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- Can osteoarthritis, sarcopenia and body composition predict loss of function?Publication . Pais, Sandra; Botelho, Marta; Moreira, Rita; Guerreiro, CarlaBackground: Elderly populations e growing in the majority of Countries in the World. Portugal in currently among the 5 most aged counties with 23,4% of it´s population over 65 and an ageing index of 182[1]. Osteoarthritis is the 3rd cause of responsible for severe disability in adults over 60 years in developed and developing countries[2]. Lack of data at a national or regional level in Portugal compromises the ability to prepare for both health and care need of aged population. Simultaneously the region of Algarve has particular geographic characteristics with 49% of the population living within 2 km from the cost (in 9% of the Algarve’s Territory). Objectives: Are aim was to study our regional population, namely the incidence of Osteoarthritis (OA) and the relation of function ability with OA, Sarcopenia and Body composition.
- Nanomedicine interventions in clinical trials for the treatment of metastatic breast cancerPublication . Moreira, Rita; Granja, Andreia; Pinheiro, Marina; Reis, SaletteBreast cancer was responsible for the deaths of 626,679 women in 2018. After decades of research, the mortality rates remain high. While the barrier of selectively killing tumor cells is not yet overcome, the search for targeted therapeutics continues. The use of nanomedicine in cancer treatment has opened up new possibilities for more precise drug-delivery systems. This review aimed to gather information and analyze recent clinical trials evaluating the therapeutic effects of nanoparticles in the treatment of metastatic breast cancer. To accomplish this, the clinicaltrials.gov database was consulted, and after employing specific exclusion criteria, 11 clinical trials were selected. Nanoparticle albumin-stabilized paclitaxel was evaluated in ten clinical trials and paclitaxel-incorporating polymeric micelles were assessed in one clinical trial. Overall, this review confirmed a clinical benefit in the use of nanoparticle albumin-stabilized paclitaxel for the treatment of breast cancer, with reduced toxicity when compared to first-line treatments. Three studies did not meet the primary endpoint, however, and so the authors advised further evaluations. Although the use of nanomedicine is revolutionizing the cancer field, to integrate this regimen into generalized clinical treatment, additional clinical trials must be performed to achieve a favorable safety and efficacy profile.
- Contralateral carotid stenosis is a predictor of long-term adverse events in carotid endarterectomyPublication . Moreira, Rita; Duarte-Gamas, Luís; Pereira-Macedo, Juliana; Pereira-Neves, António; Domingues-Monteiro, Diogo; Jácome, Filipa; Andrade, José P.; Marreiros, Ana; Rocha-Neves, JoãoContralateral carotid stenosis (cICS) has been described as a perioperative predictor of mortality after carotid endarterectomy (CEA). However, its predictive value on long-term cardiovascular events remains controversial. The study aims to assess the potential role of cICS as a long-term predictor of major adverse cardiovascular events (MACE) in patients who underwent CEA. From January 2012 to July 2020, patients undergoing CEA under regional anesthesia for carotid stenosis in a tertiary care and referral center were eligible from a prospective database, and a post hoc analysis was performed. The primary outcome consisted in the occurrence of long-term MACE. Secondary outcomes included all-cause mortality, stroke, myocardial infarction, acute heart failure, and major adverse limb events. A total of 192 patients were enrolled. With a median 50 months follow-up, chronic kidney disease (CKD) (mean survival time (MST) 51.7 vs. 103.3, P < 0.010) and peripheral artery disease (PAD) (MST 75.1 vs. 90.3, P = 0.001) were associated with decreased survival time. After propensity score matching (PSM), CKD (MST 49.1 vs. 106.0, P = 0.001) and PAD (MST 75.7 vs. 94.0, P = 0.001) maintained this association. On multivariate Cox regression analysis, contralateral stenosis was associated with higher MACE (hazard ratio (HR) = 2.035; 95% CI: 1.113-3.722, P = 0.021 and all-cause mortality (HR = 2.564; 95% CI: 1.276-5,152 P = 0.008). After PSM, only all-cause mortality (HR 2.323; 95% CI: 0.993-5.431, P = 0.052) maintained a significant association with cICS. On multivariable analysis, cICS (aHR 2.367; 95% CI: 1.174-4.771, P = 0.016), age (aHR 1.039, 95% CI: 1.008-1.070), CKD (aHR 2.803; 95% CI: 1.409-5.575, P = 0.003) and PAD (aHR 3.225, 95% CI: 1.695-6.137, P < 0.001) were independently associated with increased all-cause mortality. Contrary to MACE, cICS is a strong predictor of long-term all-cause mortality after CEA. However, MACE risk may compromise CEA benefits by other competitive events. Therefore, further studies are needed to establish the role of cICS on postoperative events and on patients' specific assessments in order to determine the best medical treatment and easy access to surgical intervention.