Browsing by Author "Pereira, D"
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- Association of ADAMTS7 gene polymorphism with cardiovascular survival in coronary artery diseasePublication . Pereira, A; Palma dos Reis, R; Rodrigues, R; Sousa, A C; Gomes, S; Borges, S; Ornelas, I; Freitas, A I; Guerra, G; Henriques, E; Rodrigues, M; Freitas, S; Freitas, C; Brehm, A; Pereira, D; Mendonça, M IRecent genetic studies have revealed an association between polymorphisms at the ADAMTS7 gene locus and coronary artery disease (CAD) risk. Functional studies have shown that a CAD-associated polymorphism (rs3825807) affects ADAMTS7 maturation and vascular smooth muscular cell (VSMC) migration. Here, we tested whether ADAMTS7 (A/G) SNP is associated with cardiovascular (CV) survival in patients with established CAD. A cohort of 1,128 patients with angiographic proven CAD, who were followed up prospectively for a mean follow-up period of 63 (range 6-182) mo, were genotyped for rs3825807 A/G. Survival statistics (Cox regression) compared heterozygous (AG) and wild-type (AA) with the reference homozygous GG. Kaplan-Meier (K-M) survival curves were performed according to ADAMTS7 genotypes for CV mortality. Results showed that 47.3% of patients were heterozygous (AG), 36.5% were homozygous for the wild-type allele (AA) and only 16.2% were homozygous for the GG genotype. During the follow-up period, 109 (9.7%) patients died, 77 (6.8%) of CV causes. Survival analysis showed that AA genotype was an independent risk factor for CV mortality compared with reference genotype GG (HR = 2.7, P = 0.025). At the end of follow-up, the estimated survival probability (K-M) was 89.8% for GG genotype, 82.2% for AG and 72.3% for AA genotype (P = 0.039). Carriage of the mutant G allele of the ADAMTS7 gene was associated with improved CV survival in patients with documented CAD. The native overfunctional ADAMTS7 allele (A) may accelerate VSMC migration and lead to neointimal thickening, atherosclerosis progression and acute plaque events. ADAMTS7 gene should be further explored in CAD for risk prediction, mechanistic and therapeutic goals.
- Epidemiological and Clinical Aspects of Cutaneous and Mucosal Leishmaniases in Portugal: Retrospective Analysis of Cases Diagnosed in Public Hospitals and Reported in the Literature between 2010 and 2020Publication . Rocha, R; Conceição, C; Gonçalves, L; Carvalho, AC; Maia, A; Martins, A; Carujo, A; Maio, A; Forra, C; Melita, C; Couto, D; Fernandes, D; Pereira, D; Leal, E; Sarmento, H; Sousa, I; Gonçalves, JP; Marinho, J; Vasconcelos, J; Cunha, J; Rodrigues, J; Silva, JM; Caley, L; Malheiro, L; Santos, L; Garcia, M; Cunha, M; Lima, M; Andrade, MM; Marques, M; Alpalhão, M; Silva, M; Ferraz, R; Soares, R; Fernandes, S; Llobet, S; Cruz, S; Guimarães, T; Branco, T; Robalo-Nunes, T; Almeida, V; Maia, CLeishmania infantum, a zoonotic vector-born parasite, is endemic in the Mediterranean region, presenting mostly as visceral (VL), but also as cutaneous (CL) and mucosal leishmaniasis (ML). This study aimed to describe the epidemiological and clinical aspects of the CL and ML cases diagnosed in mainland Portugal between 2010 and 2020. Collaboration was requested from every hospital of the Portuguese National Health System. Cases were screened through a search of diagnostic discharge codes or positive laboratory results for Leishmania infection. Simultaneously, a comprehensive literature search was performed. Descriptive statistics and hypothesis testing were performed using IBM® SPSS® Statistics. A total of 43 CL and 7 ML cases were identified, with a predominance of autochthonous cases (86%). In CL, immunosuppressed individuals constituted a significant proportion of patients (48%), and in this group, disseminated CL (22%) and simultaneous VL (54%) were common. In autochthonous cases, lesions, mostly papules/nodules (62%), were frequently observed on the head (48%). The approach to treatment was very heterogeneous. ML cases were all autochthonous, were diagnosed primarily in older immunosuppressed individuals, and were generally treated with liposomal amphotericin B. The findings suggest a need for enhanced surveillance and reporting, clinical awareness, and diagnostic capacity of these forms of leishmaniasis to mitigate underdiagnosis and improve patient outcomes. A holistic One Health approach is advocated to address the multifaceted challenges posed by leishmaniases in Portugal and beyond.
- Epidemiological and Clinical Aspects of Cutaneous and Mucosal Leishmaniases in Portugal: Retrospective Analysis of Cases Diagnosed in Public Hospitals and Reported in the Literature between 2010 and 2020Publication . Rocha, R; Conceição, C; Gonçalves, L; Carvalho, AC; Maia, A; Martins, A; Carujo, A; Maio, A; Forra, C; Melita, C; Couto, D; Fernandes, D; Pereira, D; Leal, E; Sarmento, H; Sousa, I; Gonçalves, JP; Marinho, J; Vasconcelos, J; Cunha, J; Rodrigues, J; Silva, JM; Caley, L; Malheiro, L; Santos, L; Garcia, M; Cunha, M; Lima, M; Andrade, MM; Marques, M; Alpalhão, M; Silva, M; Ferraz, R; Soares, R; Fernandes, S; Llobet, S; Cruz, S; Guimarães, T; Branco, T; Robalo-Nunes, T; Almeida, V; Maia, CLeishmania infantum, a zoonotic vector-born parasite, is endemic in the Mediterranean region, presenting mostly as visceral (VL), but also as cutaneous (CL) and mucosal leishmaniasis (ML). This study aimed to describe the epidemiological and clinical aspects of the CL and ML cases diagnosed in mainland Portugal between 2010 and 2020. Collaboration was requested from every hospital of the Portuguese National Health System. Cases were screened through a search of diagnostic discharge codes or positive laboratory results for Leishmania infection. Simultaneously, a comprehensive literature search was performed. Descriptive statistics and hypothesis testing were performed using IBM® SPSS® Statistics. A total of 43 CL and 7 ML cases were identified, with a predominance of autochthonous cases (86%). In CL, immunosuppressed individuals constituted a significant proportion of patients (48%), and in this group, disseminated CL (22%) and simultaneous VL (54%) were common. In autochthonous cases, lesions, mostly papules/nodules (62%), were frequently observed on the head (48%). The approach to treatment was very heterogeneous. ML cases were all autochthonous, were diagnosed primarily in older immunosuppressed individuals, and were generally treated with liposomal amphotericin B. The findings suggest a need for enhanced surveillance and reporting, clinical awareness, and diagnostic capacity of these forms of leishmaniasis to mitigate underdiagnosis and improve patient outcomes. A holistic One Health approach is advocated to address the multifaceted challenges posed by leishmaniases in Portugal and beyond.
- Estado actual e evolução da epidemia tabágica: em Portugal e na EuropaPublication . Precioso, J; Calheiros, JM; Pereira, D; Campos, H; Antunes, H; Rebelo, L; Bonito, JTobacco smoking is the cause of more than half million deaths/year in the European Union (EU). Monitoring smoking prevalence is an important tool to evaluate the epidemic and its evolution and to assess the effectiveness of preventive measures. The comparison between countries may help us identify good control practices. OBJECTIVE: To describe the current state and evolution of the smoking epidemic in several EU countries, and to characterize the Portuguese situation in comparison with those countries. METHODS: To characterize smoking habits and their evolution in the population over 15 years old, several Eurobarometer reports from 1995 to 2007 were used. The characterization of School Aged Children's smoking habits was based on the Health Behaviour in School-Aged Children data of 1993-4 and 2002. The Portuguese situation also used the information available from the National Health Surveys of 1987 up to 2005/06. RESULTS: The global prevalence of smoking in adult population in most of the European countries is over 25%. The average prevalence of male and female smokers in School-Aged Children over 15 years of age is approximately 18% if we consider both genders together. In most countries the prevalence of tobacco consumption is higher in girls when compared to boys. In Portugal, the prevalence in the population over 15 years of age has one of the lowest values among European countries (30,6 % for men and 11,6% for women). Despite these crude prevalence rates, high age-sex-specific prevalence rates were found in age groups 25-34 and 35-44 in men (39,9% e 44,6% respectively) and in women (17,6 e 21,2% respectively). In 2002, at the age of 15, the percentage of daily smoking girls in Portugal was 19.5%. This value reveals that Portugal is among the countries with higher prevalence rates of smoking among adolescent girls. Over the last decade (1996-2006), a decrease in tobacco consumption has been observed in most EU countries, both in adult population and in School-Aged Children. In Portugal, this consumption has levelled off in adult men and in youngsters aged 15, but shows a significant increase in female adults and school-aged girls. CONCLUSIONS: Although Portugal presents low global prevalence rates in the European context, the substantial increases observed in the young adult female population are of particular concern because of its impact on women's health and the risk of pre and post-natal associated childhood exposure. These results reveal that current preventive strategies in Portugal are ineffective in reducing smoking prevalence among children and young adults.
- New ‘refined ’criteria for the electrocardiographic assessment of athletesPublication . Rodrigues, RC; Serrão, G; Gomes, S; Pereira, D
- Rare complications also happen: epidural hematoma after spinal anesthesiaPublication . Oliveira, C; Gomes, C; Louro, J; Pereira, D
- Role of the RAD51 G172T polymorphism in the clinical outcome of cervical cancer patients under concomitant chemoradiotherapyPublication . Nogueira, A; Catarino, R; Faustino, I; Nogueira-Silva, C; Figueiredo, T; Lombo, L; Hilário-Silva, I; Pereira, D; Medeiros, RINTRODUCTION: Cervical cancer is one of the most common cancers diagnosed in women worldwide. Mammalian cells are constantly exposed to a wide variety of genotoxic agents from both endogenous and exogenous sources. The RAD51 protein is required for meiotic and mitotic recombination and plays a central role in homology-dependent recombinational repair of double-strand breaks (DSBs). Given the functional relevance of the DNA repair system on carcinogenesis, potential associations between genetic polymorphisms of DNA repair genes, cancer risk and response to therapy have been intensively evaluated. This is the first study evaluating the role of the RAD51 G172T genetic variants in cancer prognosis and clinical outcome of cervical cancer patients. MATERIAL AND METHODS: We analyzed RAD51 G172T polymorphism genotypes in cervical cancer patients who underwent a platinum-based chemotherapy in combination with radiotherapy. Genotyping was performed by Taqman™ Allelic Discrimination methodology. RESULTS AND DISCUSSION: Concerning the overall survival rates found using Kaplan-Meier method and Log Rank Test, we observed that the mean survival rates were statistically different according to the patients RAD51 genotypes. The group of patients carrying the T allele present a higher mean survival rate than the other patients (102.3months vs. 86.4months, P=0.020). Using the Cox regression analysis, we found an increased overall survival time for T-carrier patients, when compared with GG genotype, with tumor stage, age and presence of lymph nodes as covariates [hazard ratio (HR), 0.373; 95% CI, 0.181-0.770; P=0.008]. Among patients (n=193), RAD51 genotype frequency distributions were not under the influence of clinicopathologic characteristics, namely, treatment response (P=0.508), recurrence (P=0.150) and tumor stage (P=0.250). CONCLUSIONS: This is the first study evaluating the role of the RAD51 G172T genetic variants in cancer prognosis and clinical outcome of cervical cancer patients. Our results indicate an influence of the RAD51 genetic variants in overall survival of cervical cancer. Thereby, RAD51 G172T genotypes may provide additional prognostic information in cervical cancer patients who underwent cisplatin-based chemotherapy in combination with radiotherapy.
- The challenges of maintaining patient confidentiality in pediatric settings: Letter to the editorPublication . Guerreiro, G; Pereira, D
- The impact of GGH -401C>T polymorphism on cisplatin-based chemoradiotherapy response and survival in cervical cancerPublication . Silva, IH; Nogueira-Silva, C; Figueiredo, T; Lombo, L; Faustino, I; Catarino, R; Nogueira, A; Pereira, D; Medeiros, RAIMS: Cervical cancer is the third most frequent cancer in women worldwide, mostly treated with cisplatin-based chemoradiotherapy. Since it is known that folate metabolism might interfere with cisplatin effectiveness, we intended to study the influence of the Gamma Glutamyl Hydrolase -401C>T polymorphism in treatment response in cervical cancer. METHODS: We retrospectively reviewed the clinical data of 167 patients with bulky cervical cancer submitted to cisplatin-based chemoradiotherapy. The genotypes of GGH -401C>T SNP were determined by real-time PCR and statistical analysis was performed by χ(2) test and survival analysis. RESULTS: The genotypes of GGH-401C>T were significantly associated with the response to platinum-based chemoradiotherapy. Treatment response was higher in patients carrying the CC genotype, who presented a significant increased chance of treatment response (survival time in months/genotype: 91 for CC Vs 72 for CT/TT; p=0.035, log rank test). A Cox regression analysis accordingly showed that the presence of the T allele was significantly linked to a worse treatment response (HR=3.036; CI 95% 1.032-8.934, p=0.044). CONCLUSIONS: The results of our study suggested the potential interest of GGH -401C>T as a predictive factor of the outcome of cervical carcinoma treated with cisplatin-based chemoradiotherapy.