Percorrer por autor "Vale, José"
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- Magnetic resonance imaging in multiple sclerosis : an analysis of the implementation of the Portuguese consensusPublication . Cordeiro, Alyne; Marques, Ana João; Castro, Ana Rita; Silva, Cristiana; Carapinha, Duarte; Ferreira, Francisca; Schõn, Miguel; Pereira, Daniela jardim; Gabriel, João Paulo; Ruano, Luís; Santos, Mariana; Grunho, Miguel; Santos, Mónica; Vale, José; Sá, Maria José; Reis, Ricardo Soares dosIntroduction: Magnetic resonance imaging (MRI) plays a critical role in diagnosing and monitoring people with multiple sclerosis (MS). The 2020 Portuguese Consensus on Magnetic Resonance Imaging in Multiple Sclerosis aimed to standardize MRI use. This study evaluated the implementation of the consensus in clinical practice. Methods: This is an observational, retrospective, longitudinal and multicentric study comprising patients diagnosed with MS between 2019 and 2022 from seven hospital centers in Portugal. We collected demographic data and details regarding MRI requests, protocols, and reports. We performed descriptive and comparative analyses between the period before and after guideline publication. Results: We included 242 patients, mainly female (66.0%), with a mean age of 37 (SD 13). A total of 989 MRIs were performed, 69.1% follow-ups, 68.1% brain MRIs, and 31.9% spinal cord MRIs. Around half of the MRI requests fulfilled all the recommended information. All mandatory sequences in the neuroimaging protocol were performed in 82.5% of brain MRIs and 71.1% of spinal cord MRIs. None of the reports fulfilled all the suggested parameters. Magnetic resonance imaging technical description and imaging findings had the least compliance, mainly concerning gadolinium information (0.85%), lesion load (18.6%), and atrophy characterization (27.1%). After the implementation of the consensus, physicians reported the MS phenotype more often (p < 0.05) and neuroradiologists reported more technical parameters (p < 0.05). When MRIs were performed in a private setting, neuroimaging protocols were similar, but the reports fulfilled more frequently the suggested topics regarding the conclusion (p < 0.05). Conclusion: This study suggests incomplete adherence to the Portuguese Consensus on MRI in MS. Information provided by the physician in MRI requests was often insufficient, which could hamper MRI protocol planning. Magnetic resonance imaging reports were frequently lacking relevant information for the diagnosis and follow-up of MS patients. Further efforts are needed to ensure full implementation and optimize MS care.
- Natalizumab treatment modulates Peroxisome Proliferator-Activated Receptors expression in women with multiple sclerosisPublication . Ferret-Sena, Véronique; Silva, Alexandra Maia e; Sena, Armando; Cavaleiro, Inês; Vale, José; Derudas, Bruno; Chinetti-Gbaguidi, Giulia; Staels, BartPeroxisome Proliferator-Activated Receptors (PPAR) are transcription factors suggested to be involved in inflammatory lesions of autoimmune encephalomyelitis and multiple sclerosis (MS). Our objective was to assess whether Natalizumab (NTZ) therapy is associated with alterations of PPAR expression in MS patients. We analyzed gene expression of PPAR in peripheral blood mononuclear cells (PBMC) as well as blood inflammatory markers in women with MS previously medicated with first-line immunomodulators (baseline) and after NTZ therapy. No differences in PPAR𝛼, PPAR𝛽/𝛿, PPAR𝛾, and CD36 mRNA expression were found in PBMC between patients under baseline and healthy controls. At three months, NTZ increased PPAR𝛽/𝛿 mRNA (𝑝 = 0.009) in comparison to baseline, while mRNA expression of PPAR𝛾 and CD36 (a well-known PPAR target gene) was lower in comparison to healthy controls (𝑝 = 0.026 and 𝑝 = 0.028, resp.). Although these trends of alterations remain after six months of therapy, the results were not statistically significant. Osteopontin levels were elevated in patients (𝑝 = 0.002) and did not change during the follow-up period of NTZ