Browsing by Author "Oliveiros, B"
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- Accelerated age-related olfactory decline among type 1 Usher patientsPublication . Ribeiro, JC; Oliveiros, B; Pereira, P; António, N; Hummel, T; Paiva, A; Silva, EUsher Syndrome (USH) is a rare disease with hearing loss, retinitis pigmentosa and, sometimes, vestibular dysfunction. A phenotype heterogeneity is reported. Recent evidence indicates that USH is likely to belong to an emerging class of sensory ciliopathies. Olfaction has recently been implicated in ciliopathies, but the scarce literature about olfaction in USH show conflicting results. We aim to evaluate olfactory impairment as a possible clinical manifestation of USH. Prospective clinical study that included 65 patients with USH and 65 normal age-gender-smoking-habits pair matched subjects. A cross culturally validated version of the Sniffin' Sticks olfaction test was used. Young patients with USH have significantly better olfactory scores than healthy controls. We observe that USH type 1 have a faster ageing olfactory decrease than what happens in healthy subjects, leading to significantly lower olfactory scores in older USH1 patients. Moreover, USH type 1 patients showed significantly higher olfactory scores than USH type 2, what can help distinguishing them. Olfaction represents an attractive tool for USH type classification and pre diagnostic screening due to the low cost and non-invasive nature of the testing. Olfactory dysfunction should be considered among the spectrum of clinical manifestations of Usher syndrome.
- Asthma and rhinitis have different genetic profiles for IL13, IL17A and GSTP1 polymorphismsPublication . Resende, EP; Todo-Bom, A; Loureiro, C; Mota-Pinto, A; Oliveiros, B; Mesquita, L; Silva, HCBACKGROUND: Asthma and rhinitis have a complex etiology, depending on multiple genetic and environmental risk factors. An increasing number of susceptibility genes are currently being identified, but the majority of reported associations have not been consistently replicated across populations of different genetic backgrounds. PURPOSE: To evaluate whether polymorphisms of IL4R (rs1805015), IL13 (rs20541), IL17A (rs2275913) and GSTP1 (rs1695) genes are associated with rhinitis and/or asthma in adults of Portuguese ancestry. METHODS: 192 unrelated healthy individuals and 232 patients, 83 with rhinitis and 149 with asthma, were studied. All polymorphisms were detected by real time polymerase chain reaction (PCR) using TaqMan assays. RESULTS: Comparing to controls, significant association with asthma was observed for GSTP1 rs1695 AA genotype (odds ratio (OR) - 1.96; 95% CI - 1.18 to 3.25; p=0.010). The association sustains for allergic asthma (OR - 2.17; 95% CI - 1.23 to 3.80; p=0.007). IL13 rs20541 GG genotype was associated with less susceptibility to asthma (OR - 0.55, 95% CI - 0.33 to 0.94, p=0.028). Among patients, IL17A rs2275913 AA genotype was less associated with asthma than with rhinitis (OR - 0.20; 95% CI of 0.07 to 0.56; p=0.002). A similar association was found for IL13 rs20541 GG genotype (OR - 0.48; 95% CI of 0.25 to 0.93; p=0.031). There were no significant differences in the distribution of allelic and genotypic frequencies between patients and controls for the IL4R polymorphism' analyzed. CONCLUSION: These results support the existence of a significant association between GSTP1 rs1695 and IL13 rs20541 SNPs, with susceptibility to asthma, in the population studied. Different genotype profiles of IL17A and IL13 genes seem to influence the clinical pattern of disease expression mainly confined to the upper airways, as rhinitis, or including the lower airways, as asthma.
- Autogenous tooth transplantation: evaluation of pulp tissue regenerationPublication . Marques-Ferreira, M; Rabaça-Botelho, MF; Carvalho, L; Oliveiros, B; Palmeirão-Carrilho, EVJECTIVE: The aim of this study was to assess the pulp survival that occur in transplants of autologous teeth, by comparing two surgical techniques: the conventional technique (autotransplantation for newly formed alveoli), and an alternative technique, (autotransplants for alveoli in the initial phase of healing). In each surgical techniques were applied, randomly, either saline solution or Emdogain®. STUDY DESIGN: The study group comprised 26 patents, in which 28 teeth were transplanted to recipient sockets prepared mechanically. Of the 28 teeth transplanted, 4 were intentional replants, and of the remainer, 11 had the apex closed and 13 open. The mean age at the time of transplantation was 22.34 ± 8.14 years (mean ± SD). The transplantation were performed by the same operator, with the informed consent of the patient and authorized by the ethical committee of the hospital. Clinical and radiological examinations were performed during 24 to 65 months (48 ± 12.96; MED ± SD), from 10 days, 1 month, 3 months, 6 months and annually to 5.6 years. RESULTS: Only two transplanted teeth were lost, due persistent apical periodontitis, and one transplanted patient with open apex missed the treatment. In the teeth with pulp, we needed to perform root canal therapy in 9. In the 73% of the teeth with closed apex, we needed to perform root canal treatment, with no statistically significant difference found among closed apex and root canal therapy (p=0.083). In only 8% of the teeth with open apex did we need to perform root canal treatment, with an association between open apex and root canal therapy (p=0.0002). The overall success rate was 98% with significant difference for losses (p=0.0001). CONCLUSIONS: Although not a frequent procedure, it was concluded that autotransplanted teeth, performed with appropriate surgical care had a good prognosis, and can render a very useful service to the patients.
- Estudo experimental do impacto da clampagem selectiva da veia porta na função hepatocelularPublication . Tralhão, JG; Abrantes, AM; Gonçalves, C; Carvalho, C; Portela, I; Laranjo, M; Oliveiros, B; Cardoso, D; Ribeiro, AB; Botelho, MF; Castro e Sousa, FThe influence of selective clamping of the elements of hepatic pedicle in the hepatocellular function and viability were evaluated in our department. AIM: Study the effect of selective clamping of the portal vein (CPV) in hepatocellular function in an animal model with normal liver. METHOD: Three groups of Wistar rats (males, 2 months) were subjected a CPV for 60 min: group A (n=21) submitted to a continuous inflow occlusion; group B (n=12) underwent to a CPV for 30 min with 5 min of reperfusion; group C (n=10) underwent a CPV for 15 min with 5 min of reperfusion. The group D (n=9) was not subjected to a CPV. A hepatic biopsy was done at the end of surgery. The degree of tissue injury was evaluated using: 1) blood markers: AST, ALT, total bilirubin (TB), GGT alkaline-phosphatase, LDH and hepatic extraction fraction (HEF) by radioisotopic methods three days before laparotomy (BS) and after surgery (AS); 2) apoptosis, necrosis were investigated after collagenase cell isolation from hepatectomy pieces by flow-cytometry using the followed probes: propidium-iodide and annexin-V. Statistical analysis: variance analysis, post-hoc comparisons by Turkey-test (p<0.05). RESULTS: 1) Mortality: Group A - 62%, Group B - 17%, Group C - 30%, Group D - 0% (p<0.03). 2) We observed statistical differences in these parameters: ALT (p<0,025) and LDH (p<0,002) preferentially in groups A but without differences between the A,B,C and D Groups (ns). 3) We also verified a significant decrease in HEF values (p<0,0001) preferentially in group A without differences between the groups. 4) No difference were observed when analysed apoptosis and necrosis and cell viability between the groups. CONCLUSIONS: Postoperative liver failure is the leading cause of mortality after hepatectomy, however selective clamping of the portal vein, is reflected in an increase in cell viability and a decrease in the type of cell death (necrosis ou apoptosis) compared to studies carried out previously by us and thus may be regarded as an alternative to the Pringle maneuver. However, selective clamping of the portal vein for periods above 30' should be avoided, given the high mortality verified.
- Hepatectomy and liver regeneration: from experimental research to clinical applicationPublication . Tralhão, JG; Abrantes, AM; Hoti, E; Oliveiros, B; Cardoso, D; Faitot, F; Carvalho, C; Botelho, MF; Castro e Sousa, FBACKGROUND: The mechanisms and kinetics of hepatic growth have continuously been investigated. This study concerns liver regeneration in animal and patients who underwent partial hepatectomy evaluated by the hepatic extraction fraction (HEF) calculated through radioisotopic methods. METHODS: Thirty normal Wistar rats were submitted to an 85% hepatectomy, and 95 patients with primary and secondary liver tumours were included. In animal study, the liver regeneration kinetics was assessed by HEF using 99mTc-mebrofenin, the ratio liver/bodyweight and by using bromodeoxyuridine deoxyribonucleic acid incorporation. In patient study, the liver regeneration was evaluated by calculation of HEF before surgery, 5 and 30 days after hepatectomy. RESULTS: In animal, we verified a positive correlation between HEF kinetics and liver/bodyweight ratio or hepatocyte proliferation evaluated by bromodeoxyuridine deoxyribonucleic acid staining after 85% hepatectomy. In the clinical arm, no statistical differences of the HEF before hepatectomy, 5 and 30 days after hepatectomy, were observed. CONCLUSIONS: Our results support the view that human liver regeneration commences early, is fast, non-anatomical and functionally complete 5 days after hepatectomy. The fast functional liver regeneration may have a high clinical impact particularly concerning the post-operative oncological therapeutic approaches.
- Intermittent Pringle Maneuver and Hepatic Function: Perioperative Monitoring by Noninvasive ICG-ClearancePublication . Tralhão, JG; Hoti, E; Oliveiros, B; Abrantes, AM; Botelho, MF; Castro e Sousa, FBACKGROUND: Intermittent Pringle maneuver or selective portal clamping often are used to control inflow during parenchymal liver transection. This study was designed to determinate whether these maneuvers are associated with adverse hepatic function. METHODS: Resection was performed without portal clamping in 17 patients (group 1). Selective continuous portal clamping was performed in 11 patients (group 2) and the remaining 33 patients (group 3) had intermittent nonselective portal clamping (occlusion of the main portal trunk). The centers' protocol for total portal occlusion is 15-min occlusion alternated with 5-min reperfusion in patients with normal liver parenchyma or 10 min alternated with 5 min in patients with abnormal parenchyma. ICG elimination tests were conducted concurrently using a noninvasive monitor that tracks the plasma disappearance rate (PDR-ICG-%/min) and 15-min retention rate after administration (ICG-R15-%). RESULTS: There was no statistically difference between the three studied groups in terms of sequential changes of ICG-PDR (p < 0.625) or ICG-R15 (p < 0.398). CONCLUSIONS: Our study indicates that 15 min of intermittent Pringle maneuver or selective hemihepatic continuous portal clamping are safe methods of vascular control during liver resection, with no adverse effects on hepatocellular function.
- Peripheral biomarkers to diagnose obstructive sleep apnea in adults: A systematic review and meta-analysisPublication . Gaspar, LS; Santos-Carvalho, A; Santos, B; Carvalhas-Almeida, C; Barros-Viegas, AT; Oliveiros, B; Donato, H; Santos, C; Moita, J; Cavadas, C; Álvaro, ARBackground: Obstructive Sleep Apnea (OSA) has been recognized as a major health concern worldwide, given its increasing prevalence, difficulties in diagnosis and treatment, and impact on health, economy, and society. Clinical guidelines highlight the need of biomarkers to guide OSA clinical decision-making, but so far, without success. In this systematic review and meta-analysis, registered on the International Prospective Register of Systematic Reviews database (ID CRD42020132556), we proposed to gather and further explore candidates identified in the literature as potential OSA biomarkers. Methods: Search strategies for eight different databases (PubMed/Medline, Cochrane Library, Biblioteca Virtual da Saúde, Web of Science, EMBASE, World Intellectual Property Organization database, and bioRxiV and medRxiV Preprint Servers) were developed. We identified studies exploring potential biomarkers of OSA, in peripheral samples of adults, with and without OSA, with no comorbidities defined in study inclusion criteria, published after the last systematic review and meta-analysis conducted on OSA biomarkers, until May 31st, 2020. Risk of bias was assessed through the 14-item Quality Assessment Tool for Diagnostic Accuracy Studies. Demographic, clinical, and candidate biomarkers' data were collected and analyzed via random effects meta-analyses. Findings: Among the 1512 unique studies screened, 120 met the inclusion criteria and 16 studies with low risk of bias were selected for meta-analyses. The selected 16 studies enrolled a total of 2156 participants, from which 1369 were diagnosed with OSA and 787 were disease-free controls. The assessed variables showed high heterogeneity. From the 38 biomarker candidates evaluated, only two were evaluated in more than one study. Most studies pinpointed candidates with more potential for OSA prognosis. ADAM29, FLRT2 and SLC18A3 mRNA levels in PBMCs, Endocan and YKL-40 levels in serum, and IL-6 and Vimentin levels in plasma revealed the most promising candidates for OSA diagnosis. Interpretation: Although the current systematic review and meta-analysis allowed us to identify candidates to further explore as potential biomarkers in future studies, it is evident that OSA biomarkers research is still at an early stage. Most findings derive from small-size single-center study cohorts and single-candidate studies. We point several gaps in current OSA biomarker research that may guide into new directions and approaches towards the identification of OSA biomarkers.
- Predictors of echocardiographic response to cardiac resynchronization therapy: A systematic review with Meta-AnalysisPublication . Martins, R; António, N; Donato, H; Oliveiros, B
- Relations between Cardiac and Visual Phenotypes in Diabetes: A Multivariate ApproachPublication . Oliveiros, B; Sanches, M; Quendera, B; Graça, B; Guelho, D; Gomes, L; Carrilho, F; Caseiro-Alves, F; Castelo-Branco, MCardiovascular disease and diabetes represent a major public health concern. The former is the most frequent cause of death and disability in patients with type 2 diabetes, where left ventricular dysfunction is highly prevalent. Moreover, diabetic retinopathy is becoming a dominant cause of visual impairment and blindness. The complex relation between cardiovascular disease and diabetic retinopathy as a function of ageing, obesity and hypertension remains to be clarified. Here, we investigated such relations in patients with diabetes type 2, in subjects with neither overt heart disease nor advanced proliferative diabetic retinopathy. We studied 47 patients and 50 controls, aged between 45 and 65 years, equally distributed according to gender. From the 36 measures regarding visual structure and function, and the 11 measures concerning left ventricle function, we performed data reduction to obtain eight new derived variables, seven of which related to the eye, adjusted for age, gender, body mass index and high blood pressure using both discriminant analysis (DA) and logistic regression (LR). We found moderate to strong correlation between left ventricle function and the eye constructs: minimum correlation was found for psychophysical motion thresholds (DA: 0.734; LR: 0.666), while the maximum correlation was achieved with structural volume density in the neural retina (DA: 0.786; LR: 0.788). Controlling the effect of pairwise correlated visual constructs, the parameters that were most correlated to left ventricle function were volume density in retina and thickness of the retinal nerve fiber layers (adjusted multiple R2 is 0.819 and 0.730 for DA and LR), with additional contribution of psychophysical loss in achromatic contrast discrimination. We conclude that visual structural and functional changes in type 2 diabetes are related to heart dysfunction, when the effects of clinical, demographic and associated risk factors are taken into account, revealing a genuine relation between cardiac and retinal diabetic phenotypes.
- Stroke after MitraClip: Systematic Review and Meta-AnalysisPublication . Barros da Silva, P; Sousa, JP; Oliveiros, B; Donato, H; Costa, M; Gonçalves, L; Teixeira, RAIMS: To assess stroke rate after transcatheter mitral valve repair (TMVR) with MitraClip, comparing it with surgical mitral valve repair (SMVR) and optimal medical treatment (OMT). METHODS AND RESULTS: We systematically searched PubMed, Embase and Cochrane Controlled Register of Trials, in December 2018, for studies comparing TMVR with SMVR and/or OMT for the treatment of severe mitral regurgitation. Random-effects and cumulative meta-analysis was performed. Ten studies were included: seven of TMVR versus SMVR and three of TMVR versus OMT, providing a total of 1881 patients and 61 pooled strokes (16 in TMVR versus SMVR and 45 in TMVR versus OMT). There was no difference in stroke incidence between TMVR and SMVR (pooled OR 0.49 [0.17, 1.42], P=0.19). Cumulative meta-analysis showed a significantly lower stroke rate in TMVR, compared to SMVR (OR 0.4 [0.24, 0.67], P< 0.01). For TMVR versus OMT, no difference in stroke rate was identified (pooled OR 1.09 [0.60, 1.97], P=0.79). Post-procedure de novo atrial fibrillation was more frequent in SMVR when compared with TMVR. CONCLUSIONS: Although with a low number of pooled events, there was a trend for a lower post-procedure stroke in TMVR when compared with SMVR and a similar one between TMVR and OMT alone.