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- A 17-Year-Old Boy With Hemifacial Flushing and Anhidrosis.Publication . Farinha, Pedro Simões; Ferreirinha, Ana; Vilela, Beatriz; Duarte, Bruno
- TGF-β1 and Estradiol Modulate Prostaglandin Concentrations and Related Gene Expression in Equine Endometrium During the Follicular Phase.Publication . Amaral, Ana; Cerveira-Pinto, Marta; Santos, Carina; Kordowitzki, Pawel; Skarzynski, Dariusz; Ferreira-Dias, Graça; Szóstek-Mioduchowska, AnnaTransforming growth factor (TGF)-β1 is a pro-fibrotic cytokine that affects extracellular matrix (ECM) deposition and fibroblast activity. 17β-Estradiol (E), the dominant ovarian steroid during the follicular phase (FLP) of the estrous cycle, can also influence ECM remodeling and fibrosis, through prostaglandin (PG) synthesis. PGs have opposing roles in fibrosis, with PGE₂ showing anti-fibrotic effects and PGF₂α promoting fibrosis. Equine endometrosis, whose main pathological feature is fibrosis, is marked by chronic inflammation and ECM accumulation, and may involve mediators like TGF-β1, PGs, and E. This study aimed to assess how TGF-β1, E, and their combination affect PG synthase and receptors transcription (qPCR) and PG concentrations (ELISA) in equine endometrial explants during the FLP, after 24 and 48 h. Prostaglandin-endoperoxide synthase 2 (PTGS-2) mRNA was reduced with TGF-β1 and combination treatments at 24 h. Estradiol and combined treatments downregulated microsomal prostaglandin E synthase1 (PGES) mRNA at 24 h, while prostaglandin F synthase (PGFS) mRNA reduced with TGF-β1 at 24 h and with E at 48 h. The PGE₂ concentration was lower in TGF-β1 +E group than in controls and TGF-β1 alone at 48 h. In contrast, PGF₂α concentration increased with E at 24 h and TGF-β1 and TGF-β1 +E treatments at 48 h. Prostaglandin E receptor (EP)2 and 4 mRNA upregulated with the combination treatment, while prostaglandin F receptor (FP) mRNA decreased in all treated groups. These findings suggest that TGF-β1 and E interact to regulate PG pathways, with potential to drive fibrotic changes in the equine endometrium, by shifting the balance between anti- and pro-fibrotic mediators like PGE₂ and PGF₂α.
- Promoção da Saúde Oral em Jovens Adultos com Doença MentalNatário, Helena; Cordeiro, Ana Salomé; Gonçalves, Elisa; Neto, Eugénia
- Promoção da Saúde Oral em Adultos com Doença Mental: Articulação entre a Terapia Ocupacional (Hospitalar) e os Cuidados de Saúde PrimáriosGonçalves, Elisa; Neto, Eugénia; Cordeiro, Ana Salomé; Natário, Helena
- GESTAR+: Aplicação de Saúde Digital Centrada na Ocupação para Grávidas MigrantesGonçalves, Elisa; Silva, Cristina; Quaresma, Claudia
- Cuidados de Saúde Primários e o Potencial de Coordenação com os Bancos de Leite HumanoPublication . Fabrício de Almeida, Mafalda; Torgal, Ana Lúcia; Macedo, Israel; Figueiredo, Cristiano
- Continuation vs Switching Direct Oral Anticoagulant Therapy After Breakthrough Stroke.Publication . D'Anna, Lucio; Gabriele, Francesca; Ornello, Raffaele; Zini, Andrea; Paolucci, Matteo; Forlivesi, Stefano; Migliaccio, Ludovica; Viola, Maria Maddalena; Rizzo, Angelo Cascio; Sessa, Maria; Schwarz, Ghil; Tortorella, Rachele; Prandin, Gabriele; Banerjee, Soma; Desai, Gurav; Pantoni, Leonardo; Mele, Francesco; Scopelliti, Giuseppe; Cova, Ilaria; Valente, Mariarosaria; Maisano, Domenico; Bagnato, Maria Rosaria; Di Mauro, Giovanni; Bernocchi, Francesca; Di Donna, Martina Gaia; Casolla, Barbara; Mahagne, Marie-Helene; Amoretti, Marie-Eve; Morgan, Lucille; González, Laura; Rigual, Ricardo; Fuentes, Blanca; Hervás, Carlos; Candelaresi, Paolo; Andreone, Vincenzo; De Mase, Antonio; Spina, Emanuele; de Sousa, Diana Aguiar; Souza, Mariana Almudi; Fior, Alberto; Serôdio, Miguel; Caliandro, Pietro; Zauli, Aurelia; Reale, Giuseppe; Abdelalim, Ahmed; Ahmed, Sandra; Ismail, Samah Ali; Zhang, Liqun; Latimer, Tara; Elboghday, Muhammad; El Bassiouny, Ahmed; Roushdy, Tamer; Shokri, Hossam; Ferrari, Federica; Loizzo, Nicola Davide; Mazzacane, Federico; Guarion, Maria; Barone, Valentina; Forti, Paola; Rinaldi, Giuseppe; Rossi, Marco; Laterza, Vincenzo; Frisullo, Giovanni; Rizzo, Pier Andrea; Broccolini, Aldobrando; Mannino, Marina; Terruso, Valeria; Caggiula, Marcella; Scalise, Simona; Fonseca, Ana Catarina; Antunes, Bernardo; Budincevic, Hrvoje; Crnac, Petra; Viticchi, Giovanna; Silvestrini, Mauro; Barba, Lorenzo; Musienko, Viktoria; Lochner, Piergiorgio; Landau, Benjamin; Buddha, Sandeep; Khalil, Roumeisa; Piscaglia, Maria Grazia; Minguzzi, Elena; Zedde, Marialuisa; Nasreldein, Ahmed; Vinciguerra, Luisa; Costa, Luis; ElsaidElsayed, Ahmed; Al Banna, Mona; Tudisco, Laura; Mosconi, Maria Giulia; Merlino, Giovanni; De Santis, Federico; Sacco, Simona; Foschi, MatteoImportance: Management after an ischemic stroke occurring despite direct oral anticoagulant (DOAC) therapy for atrial fibrillation (AF) varies widely. Switching anticoagulation is common in clinical practice, although evidence supporting this strategy is limited. Objective: To evaluate whether continuation of treatment with the same DOAC was noninferior to switching oral anticoagulant therapy with respect to 90-day clinical outcomes. Design, setting, and participants: This multicenter registry-based cohort study with an emulated target trial design included consecutive adult patients with AF who experienced a breakthrough ischemic stroke while receiving uninterrupted DOAC therapy and resumed anticoagulation therapy thereafter. Patients were enrolled between February 2020 and February 2025, across 35 stroke centers in 9 countries in Europe and North Africa, with a standardized 90-day follow-up. The dataset was locked on September 1, 2025. A noninferiority comparison of switching vs continuation strategies was performed. Baseline confounding was addressed using inverse probability of treatment weighting (IPTW). The primary noninferiority margin was an absolute risk difference of 3.0 percentage points in 90-day net clinical benefit. Exposure: The intervention group switched to treatment with a different DOAC or vitamin K antagonist; the comparator group continued therapy with the prestroke DOAC. Main outcomes and measures: The primary outcome was 90-day net clinical benefit, defined as recurrent ischemic stroke and moderate to severe bleeding. Secondary outcomes included recurrent ischemic events, symptomatic intracerebral hemorrhage, moderate to severe extracranial bleeding, all-cause mortality, and vascular death. Results: Among 1006 patients included in the analysis (median age, 80.4 [IQR, 73.4-85.4] years; 503 female [50.0%] and 503 [50.0%] male), 463 (46.0%) continued the same DOAC therapy and 543 (54.0%) switched therapy. After IPTW adjustment, the 90-day net clinical benefit was 4.9% with switching and 5.1% with continuation, corresponding to a risk difference of -0.3 percentage points (90% CI, -2.7 to 2.1 percentage points), meeting the prespecified noninferiority criterion. For recurrent ischemic events and bleeding outcomes, the absolute differences were within the predefined noninferiority margins. Noninferiority was not demonstrated for all-cause or vascular mortality. Conclusions and relevance: In patients with breakthrough ischemic stroke during DOAC therapy, switching anticoagulation treatment was not associated with clinically meaningful short-term benefit compared with continuation. These findings suggest that switching does not provide additional benefit compared with continuing treatment with the same DOAC. Randomized clinical trials are needed to identify strategies to improve secondary prevention after a breakthrough ischemic stroke.