Publications by authors named "Rosa Alves"

17 Publications

  • Page 1 of 1

Protein-Losing Enteropathy Resolved by Eradication.

Eur J Case Rep Intern Med 2022 26;9(5):003312. Epub 2022 May 26.

Department of Internal Medicine, Hospital Garcia de Orta, Almada, Lisbon, Portugal.

Protein-losing enteropathy (PLGE) is an uncommon condition with a multifactorial origin, that is characterized by excessive loss of serum proteins into the gastrointestinal tract, resulting in hypoproteinaemia and oedema. The authors present the case of a 24-year-old man admitted to hospital for a 2-month history of lower extremity oedema and diarrhoea with a secretory pattern. Blood analysis revealed hypoalbuminaemia and iron deficiency anaemia. Liver disease and severe proteinuria were excluded as possible aetiologies. Upper gastrointestinal endoscopy revealed signs of chronic gastritis. After completion of eradication, the patient had complete resolution of clinical and laboratory abnormalities. The results suggest the need to consider less frequent aetiologies for peripheral oedema and hypoproteinaemia, such as PLGE, especially those caused by prevalent bacterial agents like .

Learning Points: Protein-losing enteropathy may be related to infection.Protein-losing enteropathy and its associated symptoms may be resolved by eradication.
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http://dx.doi.org/10.12890/2022_003312DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9239021PMC
May 2022

Biopolymer-Based Films from Sodium Alginate and Citrus Pectin Reinforced with SiO.

Materials (Basel) 2022 May 29;15(11). Epub 2022 May 29.

Packaging Technology Center, Institute of Food Technology, Av. Brasil, 2880, Campinas 13070-178, Brazil.

Blend films based on sodium alginate (SA) and citrus pectin (P) reinforced with different concentrations of SiO (0-10% /) were developed in this study. From the morphological (SEM) and structural (FT-IR) evaluation, it was verified that the incorporation of the reinforcing agent did not drastically modify the microstructure of the films, nor did new chemical bonds form. However, the XRD results suggested a slight reduction in the crystallinities of the blends by the incorporation of SiO. Among the formulations prepared, the addition of a 5% reinforcing agent was responsible for the simultaneous improvement of mechanical and barrier properties. Comparing the control sample (SA/P) with the SA/P/5.0%SiO film, the tensile strength increased from 27.7 ± 3.7 to 40.6 ± 4.5 MPa, and the water-vapor transmission rate decreased from 319.8 ± 38.7 to 288.9 ± 23.5 g m day. Therefore, SiO as a reinforcing agent in SA/P blends, represents a simple and effective strategy for improving the properties of biopolymer-based films in applications, such as packaging.
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http://dx.doi.org/10.3390/ma15113881DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9182168PMC
May 2022

Improving the mechanical properties and thermal stability of sodium alginate/hydrolyzed collagen films through the incorporation of SiO.

Curr Res Food Sci 2022 29;5:96-101. Epub 2021 Dec 29.

Packaging Technology Center, Institute of Food Technology, Campinas, São Paulo, Brazil.

Biopolymer-based films have become leading alternatives to traditional fossil-based packaging plastics. Among the countless types of biopolymers with potential for such applications, films containing hydrolyzed collagen in their composition were scarcely explored. This study determined the effect of different loads of nano-SiO (0, 2, 6, 8 and 10% w/w of sodium alginate) in the sodium alginate (SA) and hydrolyzed collagen (HC) blend films in terms of structure, thickness, mechanical properties, and thermal stability. The results indicated an improvement in the general mechanical and thermal behavior. Tensile strength increased from 18.2 MPa (control sample) to 25.4 MPa for the SA/HC film incorporated with 10% nano-SiO. In the same condition, the film's elongation at break improved impressively (from 19.5 to 35.8%). Thermal stability improved slightly for all proportions of nano-SiO. Therefore, the addition of nano-SiO can be an easy and simple strategy to improve crucial properties of SA/HC blend films, increasing its performance for future application as sustainable packaging.
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http://dx.doi.org/10.1016/j.crfs.2021.12.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8728527PMC
December 2021

O-ATRP synthesized poly(β-pinene) blended with chitosan for antimicrobial and antioxidant bio-based films production.

Int J Biol Macromol 2021 Dec 26;193(Pt A):425-432. Epub 2021 Oct 26.

Department of Bioprocesses and Materials Engineering, School of Chemical Engineering, University of Campinas, 13083-852 Albert Einstein St. N. 500, Campinas, São Paulo, Brazil. Electronic address:

Antioxidant and antimicrobial activities are important characteristics of active film packaging designed to extend food preservation. In this study, functional bio-based films were produced using different concentrations of antioxidant poly(β-pinene) bio-oligomer synthesized via organocatalyzed atom transfer radical polymerization (O-ATRP) and blended with chitosan of different molecular weights. The structural, mechanical, thermal, solubility, antioxidant, and antimicrobial properties of the films were investigated. The poly(β-pinene)-chitosan blends presented significant pores and irregularities with the increase of poly(β-pinene) concentration over 30%. Chitosan molecular weight did not show any important influence in the physical properties of the blends. Poly(β-pinene) load decreased the materials' tensile strength and melting temperature, exhibiting a plasticizing effect on chitosan chains. The antioxidant and antimicrobial activities of the films were improved by poly(β-pinene) incorporation and mainly depended on its concentration. Therefore, the incorporation of poly(β-pinene) in chitosan films can be an alternative for active packaging production.
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http://dx.doi.org/10.1016/j.ijbiomac.2021.10.156DOI Listing
December 2021

Effect of low concentrations of SiO nanoparticles on the physical and chemical properties of sodium alginate-based films.

Carbohydr Polym 2021 Oct 2;269:118286. Epub 2021 Jun 2.

Packaging Technology Center, Institute of Food Technology, Campinas, São Paulo, Brazil.

This work investigated the effect of adding low concentrations of nano-SiO (0.5, 1.0 and 1.5%) in the properties of films based on sodium alginate, to identify lower thresholds in the proportion of the reinforcing agent. It was found that, even in the smallest proportion, thermal stability of the nanocomposites improved significantly (with degradation onset increased by almost 15% compared with the control film). The surface morphology showed pronounced roughness at nano-SiO concentrations greater than 1.0%, indicating agglomeration of part of the nanomaterial. Mechanical properties were reduced for the samples with concentrations equal to 1.0 and 1.5%, however, without significant differences between them. Conversely, water vapor and light barrier properties have not undergone significant changes in any formulation. Therefore, the use of 0.5% nano-SiO in alginate films would be an easy and economically interesting way to improve thermal stability, without significantly reducing mechanical properties of the pure material.
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http://dx.doi.org/10.1016/j.carbpol.2021.118286DOI Listing
October 2021

PATENT DUCTUS ARTERIOSUS CLOSURE: EXPERIENCE FROM A TERTIARY REFERRAL CENTER.

Rev Paul Pediatr 2020 27;39:e2020013. Epub 2020 Nov 27.

Universitário de Coimbra, Coimbra, Portugal.

Objective: To characterize the number and methods of closure of Persistent Ductus Arteriosus (PDA) over a span of 16 years in a third level maternity hospital.

Methods: Retrospective study of neonates born between January 2003 and Deccember 2018, who underwent ductus arteriosus closure by pharmacological, surgical and/or transcatheter methods. Gestational age, birth weight, number and methods of closures per year were evaluated. The success rate of the pharmacologic method was calculated, as well as the mortality rate. The association between mortality and birthweight, treatment used and treatment failure was explored.

Results: There were 47,198 births, 5,156 were preterm, 325 presented PDA and 106 were eligible for closure (median gestational age - 27 weeks, birthweight <1000 g - 61%). Frequency of PDA closure decreased during the study period, especially starting in 2010. Success rate with pharmacologic treatment was 62% after the first cycle and 74% after the second. After drug failure, 12 underwent surgical ligation and two underwent transcatheter closure. Exclusive surgical ligation was indicated in four infants. Ibuprofen replaced indomethacin in 2010, and acetaminophen was used in three infants. Among the 106 infants, hospital mortality was 12% and it was associated with birthweight <1000 g (13/65 <1000 vs. 0/41 >1000 g; p=0.002) and with failure in the first pharmacologic treatment cycle (13/27 with failure, vs. 0/75 without failure; p<0.001).

Conclusions: The national consensus published in 2010 for the diagnosis and treatment of PDA in preterm infants led to a decrease in the indication for closure. Pharmacological closure was the method of choice, followed by surgical ligation. Birthweight <1000 g and first cycle of pharmacologic treatment failure were associated with higher mortality.
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http://dx.doi.org/10.1590/1984-0462/2021/39/2020013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695124PMC
August 2021

Pleural Sarcoidosis and Occult Lymphatic Anthracosis: An Unusual Symptomatic Association.

Eur J Case Rep Intern Med 2020 17;7(5):001479. Epub 2020 Mar 17.

Department of Internal Medicine, Hospital Garcia de Orta, Almada, Portugal.

Sarcoidosis is a chronic multisystemic inflammatory disease of unknown aetiology. Virtually any organ or system can be involved, resulting in a wide range of clinical presentation. Pleural sarcoidosis is rare. Pleural effusion can only be attributed to pleural sarcoidosis in the presence of pleural non-caseating epithelioid granulomas and after excluding other granulomatous diseases. Anthracosis is a pneumoconiosis associated with thoracic adenopathies and bronchial disease, and it is usually asymptomatic. The authors present a case of a middle-aged man hospitalized due to cough, right-sided pleuritic chest pain and trepopnoea.

Learning Points: To pursue a systematic and exhaustive investigation of pleuraleffusion until a definitive diagnosis is established.To recognize atypical presentations of sarcoidosis with a high degree of suspicion whenever the initial investigation is inconclusive.
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http://dx.doi.org/10.12890/2020_001479DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213820PMC
March 2020

Pericardial Effusion as an Initial Presentation of Panhypopituitarism.

Eur J Case Rep Intern Med 2020 24;7(4):001478. Epub 2020 Feb 24.

Department of Internal Medicine, Hospital Garcia de Orta, Almada, Portugal.

Pericardial effusion has a broad spectrum of clinical presentation, ranging from an incidental finding on imaging to a potentially fatal emergency such as pericardial tamponade, the most severe presentation. The authors present a case of a middle-aged male hospitalized due to shortness of breath. Initial work-up was positive for massive pericardial effusion with haemodynamic compromise. Additional study revealed panhypopituitarism. The acromegalic phenotype was suggestive of acromegaly secondary to pituitary adenoma, which had probably evolved to apoplexy. Hormone replacement was started with clinical improvement. At the 3-year follow-up, there was no evidence of recurrence of pericardial effusion. Panhypopituitarism is a relatively rare entity, but can lead to life-threatening complications such as adrenal crisis, coma and myxoedema-associated cardiac failure. Pericardial effusion is an extremely rare manifestation of secondary hypothyroidism.

Learning Points: To recognize the clinical presentation of cardiac tamponade.To recognize atypical causes of pericardial effusion, such as severe panhypopituitarism.Hormonal replacement is efficient in treating panhypopituitarism.
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http://dx.doi.org/10.12890/2020_001478DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162561PMC
February 2020

Methicillin-sensitive bacterial endarteritis associated with vascular closure device.

BMJ Case Rep 2020 Jan 19;13(1). Epub 2020 Jan 19.

Department of Internal Medicine, Hospital Garcia de Orta, Almada, Portugal

Percutaneous endovascular procedures (PEPs) are increasingly common in clinical practice. Percutaneous closure devices (PCD) ensure safe and immediate haemostasis, reducing the length of hospitalisation and improving patient comfort. Infectious complications are rare. We present the case of a 65-year-old man who was admitted to hospital because of fever and weight loss. He had a history of carotid arterial disease, having been submitted to a PEP 3 weeks before. On admission, he presented feverishly. Anaemia and elevated inflammatory parameters were detected on basic chemistry. Blood cultures isolated methicillin-sensitive and antibiotic therapy was started. He maintained fever and developed signs of right lower limb ischemia. Bacterial endocarditis was ruled out. Positron emission tomography (PET)-scan revealed inflammatory activity involving the right femoral artery (RFA). Bacterial femoral endarteritis was confirmed on surgical exploration, which documented the presence of infected PCD and occlusion of RFA. After surgery, apyrexia and improvement of ischaemic signs were achieved.
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http://dx.doi.org/10.1136/bcr-2019-232885DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035850PMC
January 2020

DNA Barcoding for the Identification of Phyllanthus Taxa Used Medicinally in Brazil.

Planta Med 2018 Nov 21;84(17):1300-1310. Epub 2018 Jun 21.

Embrapa Recursos Genéticos e Biotecnologia, Parque Estação Biológica, Brasília-DF, Brazil.

Plants of the genus principally , and are used in Brazilian folk medicine to treat kidney stones as well as other ailments, where the latter two species are listed in the Brazilian Pharmacopeia as (). However, only has been shown to be effective in a clinical setting. Nuclear ribosomal internal transcribed spacer (ITS1 - 5.8S rRNA-ITS2), internal transcribed spacer 2, and chloroplasts L, K, A-H, L, and L-F were screened for their potential as DNA barcodes for the identification of 48 taxa in Brazilian medicinal plant germplasm banks and in "living pharmacies". The markers were also tested for their ability to validate four commercial herbal teas labelled as . Using the criterion of high clade posterior probability in Bayesian phylogenetic analysis, the internal transcribed spacer, internal transcribed spacer 2, and chloroplast K, A-H, L, and L-F markers all reliably differentiated the four species, with the internal transcribed spacer and K possessing the additional advantage that the genus is well represented for these markers in the Genbank database. However, in the case of L, posterior probability for some clades was low and while and formed monophyletic groups, and accessions could not be reliably distinguished with this marker. Packaged dried herb from three Brazilian commercial suppliers comprised , but one sample was also found to be mixed with alfalfa (). An herb marketed as from a fourth supplier was found to be composed of a mixture of and .
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http://dx.doi.org/10.1055/a-0644-2688DOI Listing
November 2018

Marantic endocarditis and paraneoplastic pulmonary embolism.

BMJ Case Rep 2017 Jul 14;2017. Epub 2017 Jul 14.

Department of Internal Medicine, Hospital Garcia de Orta, Almada, Portugal.

Cancer is frequently associated with a hypercoagulable state. Almost 15% of patients with cancer will suffer a thromboembolic event during their clinical course. The aetiology of this hypercoagulable state is multifactorial and includes procoagulant factors associated with malignancy as well as the host's inflammatory response. Cancer-associated thrombophilia can present as venous thromboembolism, migratory superficial thrombophlebitis, arterial thrombosis, disseminated intravascular coagulation, thrombotic microangiopathy and rarely non-bacterial thrombotic endocarditis (NBTE). In this paper, we will describe an uncommon presentation of lung cancer on a non-smoker middle-aged woman, with recent diagnosis of pulmonary embolism, who develops malignant recurrent pleural effusion, NBTE with cutaneous and neurological manifestations, with a rapid evolution into shock, culminating in death. Diagnosis of NBTE requires a high degree of clinical suspicion. The mainstay of treatment is systemic anticoagulation to prevent further embolisation and underlying cancer control whenever is possible.
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http://dx.doi.org/10.1136/bcr-2017-220217DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5534972PMC
July 2017

Severe ischemic colitis following olanzapine use - A case report.

Rev Esp Enferm Dig 2016 Sep;108(9):595-8

Gastrenterologia e Hepatologia, Hospital de Santa Maria, Portugal.

Ischemic colitis is the most common subtype of intestinal ischemia usually resulting from vasospasm, vessel occlusion or mesenteric hypoperfusion. Neuroleptics have seldom been linked to ischemic colitis by blocking peripheral anticholinergic and antiserotonergic receptors inducing severe gastrointestinal paresis. We report a young patient with severe ischemic colitis requiring surgery due to necrosis of the bowel. After exclusion of other potential causes, olanzapine was admitted as the cause of ischemia. Clinicians should be aware of how to recognize and treat the potentially life-threatening effects of neuroleptics.
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http://dx.doi.org/10.17235/reed.2016.3944/2015DOI Listing
September 2016

[Digital educational materials in nursing: assessment by professors from an undergraduate course].

Rev Esc Enferm USP 2009 Jun;43(2):295-9

Programa de Pós-Graduação em Enfermagem da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.

This study addresses the use of digital learning materials in the format of hypertext, educational games and simulations about oxygen therapy with professors of an Undergraduate Nursing Course. It is a cross-sectional exploratory study that was carried out at the Federal University of Rio Grande do Sul in 2006 with 10 intentionally selected professors. Data collection was performed by means of a questionnaire, using a Likert scale to assess the suitability of the content, visual presentation and use of learning materials. Descriptive statistics was used to organize and process the data. Results showed that the professors approved of the presentation of educational materials, they agreed with the suitability of the contents presented and with using the materials with the content regarding oxygen therapy. There was no significant relation between the professors' opinion and their age group, nor with their computer technology knowledge, their time in teaching and the addressed contents.
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http://dx.doi.org/10.1590/s0080-62342009000200006DOI Listing
June 2009

[Undergraduate nursing students experience of a computer-based learning course].

Rev Gaucha Enferm 2008 Dec;29(4):626-32

Instituto de Cardiologia de Alvorada, Rio Grande do Sul, Brasil.

The purpose of this qualitative study was to get to know how undergraduate nursing students at the Federal University of Rio Grande do Sul Nursing School experienced the computer-based learning (CBL) course: "Socio-historical process in nursing education". Five female students, who had attended the course the previous semester, were interviewed. Data were analyzed according to the thematic analysis. The final categories were: "the students' experience in the use of computer technologies" and "the students in relation to the computer-based learning experience". The flexibilization of study time and venue was pointed out as a positive factor. The students realized that CBL requires more effort and dedication when compared to conventional learning activities. We concluded that computer-based learning is an inclusive modality that allows access of students who are already involved in the labor market.
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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

Development and use of digital educative objects in nursing teaching.

Rev Lat Am Enfermagem 2007 Jul-Aug;15(4):699-701

This paper describes a development project of digital learning objects in nursing, and the evaluation of their use by teachers and undergraduate nursing students. The strategies for their development were composed of the following stages: conceptual modeling, development of instructional materials, implementation in a virtual learning environment, and evaluation. This is an ongoing study and preliminary results demonstrate that teachers and students evaluated the design and the content of the nursing digital learning objects satisfactorily, but demonstrate difficulties in using them. The results point to the impact of innovation through the consolidation of the use of educational technologies integrated to the teaching of nursing, as well as a support program for teachers.
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http://dx.doi.org/10.1590/s0104-11692007000400028DOI Listing
December 2007

Stability of Sliced Mozzarella Cheese in Modified-Atmosphere Packaging.

J Food Prot 1996 Aug;59(8):838-844

FEA (Department of Food Technology), State University of Campinas, Instituto de Tecnologia de Alimentos (ITAL), C.P. 139, CEP 13073-001, Campinas, SP, Brazil.

Twelve slices of mozzarella cheese (about 174 g) were packaged in expanded polystyrene trays placed in gas-barrier bags under three different atmospheres (100% N, 100% CO, and 50% CO/50% N). A gas headspace-to-cheese ratio of 2.5 liters/kg of cheese was initially set in the modified-atmosphere packages. Simulating conventional Brazilian packaging, some trays were wrapped in PVC stretched film. Periodically, the product stored at 7 ± 1°C was evaluated as to its sensorial quality, microbiological condition, and physical and chemical characteristics. The head-space volume and gas composition of modified-atmosphere packages were evaluated, The mozzarella cheese did not show any physical or chemical alteration in all packaging treatments. These characteristics were not factors which limited shelf life in air or in modified atmospheres. The critical parameter was sensory degradation. The shelf life of sliced mozzarella in conventional air pack was 13 days. N atmospheres had only a minor effect on shelf life compared with air. Samples under N were satisfactory up to 16 days. A significant shelf life increase was verified under CO atmospheres compared with air, as follows: 63 days (a 385% increase) and 45 days (a 246% increase) for product under 100% CO and 50% CO/50% N, respectively. The bacteriostatic and fungistatic effects of CO were verified. The growth of psychrotrophic bacteria, molds, and yeasts was slower under CO atmospheres. Mold and yeast development was inhibited under 100% CO (2 liters of CO per kg of cheese).
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http://dx.doi.org/10.4315/0362-028X-59.8.838DOI Listing
August 1996
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