Browsing by Issue Date, starting with "2021-07"
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- Medicina Interna: o Passado, o Presente e o Futuro. A Visão do InternoPublication . Moreira Marques, TO presente artigo é um exercício de reflexão um interno sobre a evolução da especialidade, desde o seu passado, passando pelo presente e pensando o futuro. Tem como objectivo promover a reflexão e discussão interpares sobre a evolução da especialidade, os objectivos comuns para o futuro e, ainda, a importância da revisão das necessidades de formação e curriculares nesta especialidade.
- FOAM Is the Concept: a Medicina no Século XXI?Publication . Barosa, M; Caiado Ferreira, P; Pimentel, B; Marques, R
- Lymphocyte Subpopulations in Sjögren’s Syndrome Are Distinct in Anti-SSA-Positive Patients and Related to Disease ActivityPublication . Barcelos, F; Martins, C; Madeira, N; Dias, M; Cardigos, J; Alves, N; Vaz-Patto, J; Cunha-Branco, J; Borrego, LMObjectives: Sjögren's syndrome (SjS) patients exhibit great phenotypical heterogeneity, reinforced by the positiveness of anti-SSA antibody. We aimed to evaluate lymphocyte subpopulations in SSA-positive (SSA+SjS) and SSA-negative (SSA-SjS) SjS patients, Sicca patients, and healthy controls (HC), and to investigate associations between lymphocyte subpopulations and disease activity in SjS. Methods: According to the fulfilment of the ACR/EULAR 2016 classification criteria, patients were included as SjS or as Sicca. HC were selected from the Ophthalmology outpatient clinic. Lymphocyte subpopulations were characterized by flow cytometry. Statistical analysis was performed with GraphPad PrismTM, with statistical significance concluded if p < 0.05. Results: We included 53 SjS patients (38 SSA+ and 15 SSA-), 72 Sicca, and 24 HC. SSA+SjS patients presented increased IL-21+CD4+ and CD8+ T cells compared to Sicca and HC, whereas compared to SSA-SjS patients, only IL-21+CD4+ T cell percentages were increased and Tfh17 percentages and numbers were decreased. Compared to Sicca and HC, SSA+SjS patients had higher levels of CD24HiCD38Hi B cells, naïve B cells, and IgM-/+CD38++ plasmablasts, and lower levels of memory B cells, including CD24HiCD27+ B cells. SSA+SjS patients with clinically active disease had positive correlations between ESSDAI and IL-21+CD4+ (p = 0.038, r = 0.456) and IL-21+CD8+ T cells (p = 0.046, r = 0.451). Conclusions: In SjS, a distinct lymphocyte subset distribution profile seems to be associated with positive anti-SSA. Moreover, the association between ESSDAI and IL-21+CD4+ and IL-21+CD8+ (follicular) T cells in SSA+SjS patients suggests the involvement of these cells in disease pathogenesis and activity, and possibly their utility for the prognosis and assessment of response to therapy. Key Points • SSA+SjS patients have a pronounced naïve/memory B cell imbalance. • SSA+SjS patients have more active disease associated with IL-21+CD4+ and IL-21+CD8+ follicular T cell expansion. • IL-21+CD4+ and IL-21+CD8+ T cell quantification may be useful for the prognosis and assessment of response to therapy.
- Alvarez Waves in Pregnancy: a Comprehensive ReviewPublication . Russo, S; Batista, A; Esgalhado, F; Palma dos Reis, C; Serrano, F; Vassilenko, V; Ortigueira, MAlvarez waves are local rhythmic contractions of the myometrium with high frequency and low intensity. They can be detected using internal or external tocography and electrohysterography. Some researchers correlate these small contractions with the initiation of labor, since they have been described as a pattern representing the uterine response to prostaglandin production. Other authors either do not validate a causality relation between Alvarez waves and labor or suggest that they have low predictive value for preterm labor. Alvarez waves' research has become a multidisciplinary subject with inputs ranging from medical science, biomedical engineering, and related areas. A comprehensive review is herein conducted to summarize the state of the art regarding Alvarez waves and their role in the initiation of labor, namely in preterm birth. The results show that a large number of studies have analyzed and characterized Alvarez waves without necessarily digging into their relationship with labor. Publications were categorized in three groups: (A) reports about morphology and characterization of Alvarez waves; (B) publications reporting a positive causality relation between Alvarez waves and labor; and (C) publications reporting an absence of causality regarding the previous hypothesis. Studies in group B outnumbered those in group C. A critical analysis is presented.
- O Impacto da Nutrição na Taxa de Infeção nos Doentes Submetidos a Cirurgia do PâncreasPublication . Barreto, AA nutrição é essencial para a otimização e recuperação do doente. Quando comprometida, poderá ocorrer consequências na recuperação e evolução do quadro clínico. O objetivo deste artigo foi reunir e sintetizar estudos sobre o impacto da nutrição na taxa de infeção nos doentes submetidos a cirurgia do pâncreas. Como metodologia utilizada recorreu-se a uma revisão da literatura utilizando como descritores “nutritional”, “pancreatic surgery” e “infection control”. Foram incluídos artigos de estudos com doentes submetidos a cirurgia programada do pâncreas e estudos disponíveis na totalidade. Após aplicação dos critérios de inclusão e exclusão foram encontrados 16 artigos. Constatou-se que todos os artigos analisados, atribuem relevância à nutrição como fator de recuperação do doente após ser submetido a cirurgia do pâncreas, bem como na redução das taxas de infeção. Adicionalmente verificou-se que a avaliação do estado nutricional antes e após a cirurgia é essencial para detetar e intervir em possíveis estados de desnutrição.
- EHRA Expert Consensus Statement and Practical Guide on Optimal Implantation Technique for Conventional Pacemakers and implantable cardioverter-defibrillators: endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), and the Latin-American Heart Rhythm Society (LAHRS)Publication . Burri, H; Starck, C; Auricchio, A; Biffi, M; Burri, M; D’Avila, A; Deharo, JC; Glikson, M; Israel, C; Lau, CP; Leclercq, C; Love, C; Nielsen, J; Vernooy, K; Dagres, N; Boveda, S; Butter, C; Marijon, E; Braunschweig, F; Mairesse, G; Gleva, M; Defaye, P; Zanon, F; Lopez-Cabanillas, N; Guerra, J; Vassilikos, V; Oliveira, MWith the global increase in device implantations, there is a growing need to train physicians to implant pacemakers and implantable cardioverter-defibrillators. Although there are international recommendations for device indications and programming, there is no consensus to date regarding implantation technique. This document is founded on a systematic literature search and review, and on consensus from an international task force. It aims to fill the gap by setting standards for device implantation.
- Is There a Gender Gap in National Cardiology Research? Data Review from the Portuguese Journal of CardiologyPublication . Timóteo, ATgA ender gap is apparent in several professional areas, including in Medicine and particularly in the Cardiovascular field. We present a brief review of the subject and we analyse data from the Portuguese Journal of Cardiology regarding women authorship.
- The Association Between Hepatitis B Virus Infection and Nonliver Malignancies in Persons Living with HIV: Results from the EuroSIDA StudyPublication . Mocroft, A; Miro, J; Wandeler, G; Llibre, J; Boyd, A; van Bremen, K; Beniowski, M; Mikhalik, J; Cavassini, M; Maltez, F; Duvivier, C; Uberti Foppa, C; Knysz, B; Bakowska, E; Kuzovatova, E; Domingo, P; Zagalo, A; Viard, JP; Degen, O; Milinkovic, A; Benfield, T; Peters, L; Harxhi, A; Losso, M; Kundro, M; Schmied, B; Zangerle, R; Karpov, I; Vassilenko, A; Mitsura, V; Paduto, D; Clumeck, N; De Wit, S; Delforge, M; Florence, E; Vandekerckhove, L.; Hadziosmanovic, V; Begovac, J; Machala, L; Sedlacek, D; Kronborg, G; Gerstoft, J; Katzenstein, T; Pedersen, C; Johansen, I; Ostergaard, L; Wiese, L; Moller, N; Nielsen, L; Zilmer, K; Smidt, J; Aho, I; Lacombe, K; Pradier, C; Fontas, E; Rockstroh, J; Behrens, G; Hoffmann, C; Stellbrink, H; Stefan, C; Bogner, J; Fätkenheuer, G; Chkhartishvili, N; Sambatakou, H; Adamis, G; Paissios, N; Szlávik, J; Gottfredsson, M; Devitt, E; Tau, L; Turner, D; Burke, M; Shahar, E; Wattad, L; Elinav, H; Haouzi, M; Elbirt, D; D’Arminio Monforte, A; Esposito, R; Mazeu, I; Mussini, C; Mazzotta, F; Gabbuti, A; Lazzarin, A; Castagna, A; Gianotti, N; Galli, M; Ridolfo, A; Uzdaviniene, V; Matulionyte, R; Staub, T; Hemmer, R; Dragas, S; Stevanovic, M; vd Valk, M; Trajanovska, J; Reikvam, D; Maeland, A; Bruun, J; Szetela, B; Inglot, M; Flisiak, R; Grzeszczuk, A; Parczewski, M; Maciejewska, K; Aksak‐Was, B; Mularska, E; Jablonowska, E; Kamerys, J; Wojcik, K; Mozer‐Lisewska, I; Rozplochowski, B; Mansinho, K; Radoi, R; Oprea, C; Gusev, D; Trofimova, T; Khromova, I; Borodulina, E; Ranin, J; Tomazic, J; Miró, J; Laguno, M; Martinez, E; Garcia, F; Blanco, J; Martinez‐Rebollar, M; Mallolas, J; Callau, P; Rojas, J; Inciarta, A; Moreno, S; del Campo, S; Clotet, B; Jou, A; Paredes, R; Puig, J; Santos, J; Gutierrez, M; Mateo, G; Sambeat, M; Laporte, J; Svedhem, V; Thalme, A; Sönnerborg, A; Brännström, J; Flamholc, L; Kusejko, K; Braun, D; Calmy, A; Furrer, H; Battegay, M; Schmid, P; Kuznetsova, A; Sluzhynska, M; Johnson, A; Simons, E; Edwards, S; Phillips, A; Johnson, M; Orkin, C; Winston, A; Clarke, A; Leen, C; Karpov, I; Losso, M; Lundgren, J; Rockstroh, J; Aho, I; Rasmussen, L; Svedhem, V; Pradier, C; Chkhartishvili, N; Matulionyte, R; Oprea, C; Kowalska, J; Begovac, J; Miró, J; Guaraldi, G; Paredes, R; Paredes, R; Larsen, J; Bojesen, A; Neesgaard, B; Jaschinski, N; Fursa, O; Sather, M; Raben, D; Hansen, E; Kristensen, D; Fischer, A; Jensen, S; Elsing., T; Phillips, A; Reekie, J; Cozzi‐Lepri, A; Amele, S; Pelchen‐Matthews, A; Roen, A; Tusch, E; Bannister., WObjectives: The aim of this study was to assess the impact of hepatitis B virus (HBV) infection on non-liver malignancies in people living with HIV (PLWH). Methods: All persons aged ≥ 18 years with known hepatitis B virus (HBV) surface antigen (HBsAg) status after the latest of 1 January 2001 and enrolment in the EuroSIDA cohort (baseline) were included in the study; persons were categorized as HBV positive or negative using the latest HBsAg test and followed to their first diagnosis of nonliver malignancy or their last visit. Results: Of 17 485 PLWH included in the study, 1269 (7.2%) were HBV positive at baseline. During 151 766 person-years of follow-up (PYFU), there were 1298 nonliver malignancies, 1199 in those currently HBV negative [incidence rate (IR) 8.42/1000 PYFU; 95% confidence interval (CI) 7.94-8.90/1000 PYFU] and 99 in those HBV positive (IR 10.54/1000 PYFU; 95% CI 8.47-12.62/1000 PYFU). After adjustment for baseline confounders, there was a significantly increased incidence of nonliver malignancies in HBV-positive versus HBV-negative individuals [adjusted incidence rate ratio (aIRR) 1.23; 95% CI 1.00-1.51]. Compared to HBV-negative individuals, HBsAg-positive/HBV-DNA-positive individuals had significantly increased incidences of nonliver malignancies (aIRR 1.37; 95% CI 1.00-1.89) and NHL (aIRR 2.57; 95% CI 1.16-5.68). There was no significant association between HBV and lung or anal cancer. Conclusions: We found increased rates of nonliver malignancies in HBsAg-positive participants, the increases being most pronounced in those who were HBV DNA positive and for NHL. If confirmed, these results may have implications for increased cancer screening in HIV-positive subjects with chronic HBV infection.