Browsing by Author "Monteiro, C."
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- Aspergillus Species and Antifungals Susceptibility in Clinical Setting in the North of Portugal: Cryptic Species and Emerging Azoles Resistance in A. fumigatusPublication . Pinto, E.; Monteiro, C.; Maia, M.; Faria, M.; Lopes, V.; Lameiras, C.; Pinheiro, D.Aspergillus spp. are agents of a broad-spectrum of diseases among humans. Their growing resistance to azoles, the cornerstone in the management of human aspergillosis, is a worrisome problem around the world. Considering lack of data from Portugal on this topic, particularly from the northern region, a retrospective surveillance study was planned to assess frequency of cryptic Aspergillus species and azoles resistance. A total of 227 clinical isolates, mainly from the respiratory tract (92.1%), collected from three hospitals serving a population of about three million people, were studied for their epidemiology and antifungal susceptibility patterns determined by the E.DEF.9.3 protocol of EUCAST. Employing molecular methods, seven Aspergillus complexes were identified; Aspergillus fumigatus sensu stricto was the most frequent isolate (86.7%). A 7.5% prevalence of cryptic species was found; A. welwitschiae (A. niger complex-3.1%) and A. lentulus (A. fumigatus complex-2.2%) were the most frequent. Amongst cryptic species, it was found a percentage of resistance to voriconazole, posaconazole and isavuconazole of 47.1, 82.4, and 100%, respectively. Five A. fumigatus sensu stricto showed pan-azole resistance. Sequencing their cyp51A gene revealed the presence of one isolate with TR46/Y121F/T289A mutation and two isolates with TR34/L98H mutation. This study emphasizes the need to identify strains to the species level and to evaluate their antifungal susceptibility in all human originated Aspergillus spp. isolates, particularly those from invasive aspergillosis.
- Edema Hemorrágico Agudo da Infância - Dois Casos ClínicosPublication . Monteiro, C.; Lira, S.; Zilhão, C.ABSTRACT Acute Hemorrhagic Edema of Infancy (AHEI) is a leukocytoclastic vasculitis that is usually observed before the age of two years. It is characterized by large purpuric lesions on the face and extremities along with edema of the hands and feet. The exuberance of the lesions is opposed to the well-being of the child and the benign course, resolving in 1-3 weeks, usually without recurrence or long term complications. The authors present two clinical cases of AHEI diagnosed one month apart.
- Epigenome-wide DNA methylation profiling of periprostatic adipose tissue in prostate cancer patients with excess adiposity-a pilot studyPublication . Cheng, Y.; Monteiro, C.; Matos, A.; You, J.; Fraga, A.; Pereira, C.; Catalán, V.; Rodríguez, A.; Gómez-Ambrosi, J.; Frühbeck, G.; Ribeiro, R.; Hu, P.Background: Periprostatic adipose tissue (PPAT) has been recognized to associate with prostate cancer (PCa) aggressiveness and progression. Here, we sought to investigate whether excess adiposity modulates the methylome of PPAT in PCa patients. DNA methylation profiling was performed in PPAT from obese/overweight (OB/OW, BMI > 25 kg m-2) and normal weight (NW, BMI < 25 kg m-2) PCa patients. Significant differences in methylated CpGs between OB/OW and NW groups were inferred by statistical modeling. Results: Five thousand five hundred twenty-six differentially methylated CpGs were identified between OB/OW and NW PCa patients with 90.2% hypermethylated. Four hundred eighty-three of these CpGs were found to be located at both promoters and CpG islands, whereas the representing 412 genes were found to be involved in pluripotency of stem cells, fatty acid metabolism, and many other biological processes; 14 of these genes, particularly FADS1, MOGAT1, and PCYT2, with promoter hypermethylation presented with significantly decreased gene expression in matched samples. Additionally, 38 genes were correlated with antigen processing and presentation of endogenous antigen via MHC class I, which might result in fatty acid accumulation in PPAT and tumor immune evasion. Conclusions: Results showed that the whole epigenome methylation profiles of PPAT were significantly different in OB/OW compared to normal weight PCa patients. The epigenetic variation associated with excess adiposity likely resulted in altered lipid metabolism and immune dysregulation, contributing towards unfavorable PCa microenvironment, thus warranting further validation studies in larger samples.
- Infecção pelo vírus Epstein Barr e hepatitePublication . Moreira, E.; Machado, Â.; Machado, L.; Xavier, C.; Monteiro, C.; Cunha, J.; Garrido, C.Introdução: A infecção pelo vírus Epstein Barr (VEB) tem uma prevalência elevada sendo mais de 90% da população mundial seropositiva. A maioria das infecções primárias pelo VEB é subclínica. As complicações agudas são raras mas potencialmente letais. Caso clínico: Criança do sexo feminino com nove anos admitida por febre elevada com 13 dias de evolução, dor abdominal e odinofagia. Os exames auxiliares de diagnósticos foram compatíveis com hepatite vírica aguda com valores muito aumentados de transaminases. O diagnóstico de infecção pelo VEB foi confirmado pela presença de anticorpos heterófilos e marcadores serológicos. Conclusão: Na infecção pelo VEB a lesão hepática, apesar de frequente, é habitualmente insignificante, com aumento leve e auto-limitado das transaminases, sendo raros os casos de hepatite clinicamente relevante. Os autores descrevem este caso pela inesperada gravidade das alterações hepáticas. ABSTRACT Introduction: Epstein Barr virus (VEB) infection is very prevalent with more than 90% of adults worldwide seropositive. The majority of primary VEB infections are subclinical. Acute complications are very rare but can be fatal. Case report: A nine-year-old girl was admitted with fever for 13 days, abdominal pain and sore throat. Laboratory results were consistent with an acute viral hepatitis with markedly elevated transaminase levels. The diagnosis of acute VEB infection was confirmed by the positive heterophilic antibody monospot assay and serological markers. Conclusion: Although common, liver disease is usually mild with transient elevation of serum aminotransferases, and cases of severe hepatitis are rare. The authors report this case due to the unexpected severity of liver disease.
- Predictive model of response to tafamidis in hereditary ATTR polyneuropathyPublication . Monteiro, C.; Mesgazardeh, J.; Anselmo, J.; Fernandes, J.; Novais, M.; Rodrigues, C.; Brighty, G.; Powers, D.; Powers, E.; Coelho, T.; Kelly, J.BACKGROUNDThe hereditary transthyretin (TTR) amyloidoses are a group of diseases for which several disease-modifying treatments are now available. Long-term effectiveness of these therapies is not yet fully known. Moreover, the existence of alternative therapies has resulted in an urgent need to identify patient characteristics that predict response to each therapy.METHODSWe carried out a retrospective cohort study of 210 patients with hereditary TTR amyloidosis treated with the kinetic stabilizer tafamidis (20 mg qd). These patients were followed for a period of 18-66 months, after which they were classified by an expert as responders, partial responders, or nonresponders. Correlations between baseline demographic and clinical characteristics, as well as plasma biomarkers and response to therapy, were investigated.RESULTS34% of patients exhibited an almost complete arrest of disease progression (classified by an expert as responders); 36% had a partial to complete arrest in progression of some but not all disease components (partial responders); whereas the remaining 30% continued progressing despite therapy (nonresponders). We determined that disease severity, sex, and native TTR concentration at the outset of treatment were the most relevant predictors of response to tafamidis. Plasma tafamidis concentration after 12 months of therapy was also a predictor of response for male patients. Using these variables, we built a model to predict responsiveness to tafamidis.CONCLUSIONOur study indicates long-term effectiveness for tafamidis, a kinetic stabilizer approved for the treatment of hereditary TTR amyloidosis. Moreover, we created a predictive model that can be potentially used in the clinical setting to inform patients and clinicians in their therapeutic decisions.
- Treat to target: temporomandibular joint (TMJ) arthritis in children with juvenile idiopathic arthritis (JIA) – experience of Centro Hospitalar do PortoPublication . Nascimento, J.; Zilhão, C.; Pinto, A.; Miranda, C.; Monteiro, C.; Guedes, M.