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- Gla-Rich protein, magnesium and phosphate associate with mitral and aortic valves calcification in Didabetic patients with moderate CKDPublication . Silva, Ana P.; Viegas, Carla; Guilherme, Patrícia; Tavares, Nelson; Dias, Carolina; Rato, Fátima; Santos, Nélio; Faísca, Marília; de Almeida, Edgar; Neves, Pedro L.; Simes, Dina C.Accelerated and premature cardiovascular calcification is a hallmark of chronic kidney disease (CKD) patients. Valvular calcification (VC) is a critical indicator of cardiovascular disease and all-cause mortality in this population, lacking validated biomarkers for early diagnosis. Gla-rich protein (GRP) is a cardiovascular calcification inhibitor recently associated with vascular calcification, pulse pressure, mineral metabolism markers and kidney function. Here, we examined the association between GRP serum levels and mitral and aortic valves calcification in a cohort of 80 diabetic patients with CKD stages 2–4. Mitral and aortic valves calcification were detected in 36.2% and 34.4% of the patients and associated with lower GRP levels, even after adjustments for age and gender. In this pilot study, univariate, multivariate and Poisson regression analysis, show that low levels of GRP and magnesium (Mg), and high levels of phosphate (P) are associated with mitral and aortic valves calcification. Receiver operating characteristic (ROC) curves showed that the area under the curve (AUC) values of GRP for mitral (0.762) and aortic (0.802) valves calcification were higher than those of Mg and P. These results suggest that low levels of GRP and Mg, and high levels of P, are independent and cumulative risk factors for VC in this population; the GRP diagnostic value might be potentially useful in cardiovascular risk assessment.
- Quantitation overcoming Matrix effects of Lipophilic toxins in Mytilus galloprovincialis by liquid chromatography-full scan high resolution mass spectrometry analysis (LC-HR-MS)Publication . Costa, Camila Q. V. da; Afonso, Inês I.; Lage, Sandra; Costa, Pedro Reis; Canario, Adelino; Silva, José Paulo daThe analysis of marine lipophilic toxins in shellfish products still represents a challenging task due to the complexity and diversity of the sample matrix. Liquid chromatography coupled with mass spectrometry (LC-MS) is the technique of choice for accurate quantitative measurements in complex samples. By combining unambiguous identification with the high selectivity of tandem MS, it provides the required high sensitivity and specificity. However, LC-MS is prone to matrix effects (ME) that need to be evaluated during the development and validation of methods. Furthermore, the large sample-to-sample variability, even between samples of the same species and geographic origin, needs a procedure to evaluate and control ME continuously. Here, we analyzed the toxins okadaic acid (OA), dinophysistoxins (DTX-1 and DTX-2), pectenotoxin (PTX-2), yessotoxin (YTX) and azaspiracid-1 (AZA-1). Samples were mussels (Mytilus galloprovincialis), both fresh and processed, and a toxin-free mussel reference material. We developed an accurate mass-extracted ion chromatogram (AM-XIC) based quantitation method using an Orbitrap instrument, evaluated the ME for different types and extracts of mussel samples, characterized the main compounds co-eluting with the targeted molecules and quantified toxins in samples by following a standard addition method (SAM). An AM-XIC based quantitation of lipophilic toxins in mussel samples using high resolution and accuracy full scan profiles (LC-HR-MS) is a good alternative to multi reaction monitoring (MRM) for instruments with HR capabilities. ME depend on the starting sample matrix and the sample preparation. ME are particularly strong for OA and related toxins, showing values below 50% for fresh mussel samples. Results for other toxins (AZA-1, YTX and PTX-2) are between 75% and 110%. ME in unknown matrices can be evaluated by comparing their full scan LC-HR-MS profiles with those of known samples with known ME. ME can be corrected by following SAM with AM-XIC quantitation if necessary.
- Avaliação da eficiência dos serviços de radiologia da união europeia através da técnica data envelopment analysisPublication . Carriço, Catarina Oliveira; Amado, Carla; Santos, Sérgio Pereira dosA Radiologia é uma especialidade médica que se destaca pela diferenciação e inovação tecnológica integradas em cada equipamento, pelo que o desenvolvimento tecnológico que tem ocorrido ao longo dos anos acarreta elevados custos, contribuindo para um aumento da despesa pública em saúde. Deste modo, avaliar o desempenho dos serviços de Radiologia, garantindo a sua eficiência, é fundamental para garantir melhores resultados nos cuidados de saúde prestados à população. O objetivo principal deste trabalho é aplicar a técnica Data Envelopment Analysis (DEA) para avaliar a eficiência dos serviços de Radiologia dos países da União Europeia (UE), identificando os países com melhores e piores resultados de eficiência. Para este estudo, foram utilizados dados do ano de 2015 para 22 países da União Europeia. Os resultados revelam uma variação na eficiência dos serviços de Radiologia nestes países, com uma média de eficiência técnica de 68,40% e um desvio-padrão de 27,12%, indicando assim a existência de diferenças entre países e de um potencial de melhoria para alguns. Dos 22 países em estudo, os serviços de Radiologia do Luxemburgo, da Bélgica e de Portugal foram considerados eficientes e servem de benchmarks para um número significativo de países. Estes resultados demonstram o potencial papel estratégico do DEA para o planeamento eficiente dos serviços de Radiologia de cada país