Browsing by Author "Duarte-Ramos, Filipa"
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- Adiponectin, Leptin, and IGF-1 are useful diagnostic and stratification biomarkers of NAFLDPublication . Marques, Vanda; Afonso, Marta; Bierig, Nina; Duarte-Ramos, Filipa; Santos-Laso, Álvaro; Jimenez-Agüero, Raul; Eizaguirre, Emma; Bujanda, Luis; Pareja, Maria J.; Luís, Rita; Costa, Adília; Machado, Mariana; Alonso, Cristina; Arretxe, Enara; Alustiza, José M.; Krawczyk, Marcin; Lammert, Frank; Tiniakos, Dina G.; Flehmig, Bertram; Cortez-Pinto, Helena; Banales, Jesus M.; Castro, Rui E.; Normann, Andrea; Rodrigues, Cecília M. P.Background: Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease where liver biopsy remains the gold standard for diagnosis. Here we aimed to evaluate the role of circulating adiponectin, leptin, and insulin-like growth factor 1 (IGF-1) levels as non-invasive NAFLD biomarkers and assess their correlation with the metabolome. Materials and Methods: Leptin, adiponectin, and IGF-1 serum levels were measured by ELISA in two independent cohorts of biopsy-proven obese NAFLD patients and healthy-liver controls (discovery: 38 NAFLD, 13 controls; validation: 194 NAFLD, 31 controls) and correlated with clinical data, histology, genetic parameters, and serum metabolomics. Results: In both cohorts, leptin increased in NAFLD vs. controls (discovery: AUROC 0.88; validation: AUROC 0.83; p < 0.0001). The leptin levels were similar between obese and non-obese healthy controls, suggesting that obesity is not a confounding factor. In the discovery cohort, adiponectin was lower in non-alcoholic steatohepatitis (NASH) vs. non-alcoholic fatty liver (AUROC 0.87; p < 0.0001). For the validation cohort, significance was attained for homozygous for PNPLA3 allele c.444C (AUROC 0.63; p < 0.05). Combining adiponectin with specific serum lipids improved the assay performance (AUROC 0.80; p < 0.0001). For the validation cohort, IGF-1 was lower with advanced fibrosis (AUROC 0.67, p < 0.05), but combination with international normalized ratio (INR) and ferritin increased the assay performance (AUROC 0.81; p < 0.01). Conclusion: Serum leptin discriminates NAFLD, and adiponectin combined with specific lipids stratifies NASH. IGF-1, INR, and ferritin distinguish advanced fibrosis.
- COMPRIME - COnhecer Mais PaRa Intervir MElhor: preliminary mapping of municipal level determinants of COVID-19 transmission in Portugal at different moments of the 1st epidemic wavePublication . Sousa, Paulo; Marques Da Costa, Nuno; Marques Da Costa, Eduarda; Rocha, Jorge; Ricoca Peixoto, Vasco; Campos Fernandes, Adalberto; Gaspar, Rogério; Duarte-Ramos, Filipa; Abrantes, Patrícia; Leite, AndreiaThe role of demographic and socio-economic determinants of COVID-19 transmission is still unclear and is expected to vary in different contexts and epidemic periods. Exploring such determinants may generate a hypothesis about transmission and aid the definition of prevention strategies. Objectives: To identify municipality-level demographic and socio-economic determinants of COVID-19 in Portugal. Methods: We assessed determinants of COVID-19 daily cases at 4 moments of the first COVID-19 epidemic wave in Portugal, related with lockdown and post-lockdown measures. We selected 60 potential determinants from 5 dimensions: population and settlement, disease, economy, social context, and mobility. We conducted a multiple linear regression (MLR) stepwise analysis (p < 0.05) and an artificial neural network (ANN) analysis with the variables to identify predictors of the number of daily cases. Results: For MLR, some of the identified variables were: resident population and population density, exports, overnight stays in touristic facilities, the location quotient of employment in accommodation, catering and similar activities, education, restaurants and lodging, some industries and building construction, the share of the population working outside the municipality, the net migration rate, income, and renting. In ANN, some of the identified variables were: population density and resident population, urbanization, students in higher education, income, exports, social housing buildings, production services employment, and the share of the population working outside the municipality of residence. Conclusions: Several factors were identified as possible determinants of COVID- 19 transmission at the municipality level. Despite limitations to the study, we believe that this information should be considered to promote communication and prevention approaches. Further research should be conducted.
- Dashboard COMPRIME-COMPRIM_MOV: monitorização espácio-temporal da Covid-19 em PortugalPublication . Marques Da Costa, Nuno; Mileu, Nelson; Alves, André; Marques Da Costa, Eduarda; Rocha, Jorge; Abrantes, Patrícia; Freitas, Carlos; Sousa, Paulo; Campos Fernandes, Adalberto; Gaspar, Rogério; Duarte-Ramos, Filipa; Portugal, RuiO interesse por informação credível e atualizada no âmbito da evolução pandémica conduziu à necessidade de desenvolver um instrumento que permitisse a disseminação de informação sobre o estado da difusão da COVID-19. No dashboard desenvolvido é integrada informação segundo quatro níveis territoriais desde março de 2020 até à atualidade. Suportada no ArcGIS Online, foram desenvolvidas outras soluções exteriores a este sistema que permitiram agilizar e introduzir funcionalidades para aumentar a interatividade e o dinamismo na consulta de informação disponibilizada. Disto resultou um instrumento de vigilância epidemiológica que permite a todos monitorizar em tempo útil a evolução da doença no território nacional.
- Effects of economic recession on elderly patients’ perceptions of access to health care and medicines in PortugalPublication . Costa, Filipa Alves da; Teixeira, Inês; Duarte-Ramos, Filipa; Proença, Luís; Pedro, Ana Rita; Furtado, Cristina; Silva, José Aranda da; Cabrita, JoséBackground In view of the current financial and demographic situation in Portugal, accessibility to health care may be affected, including the ability to adhere to medication. Objective To evaluate the perceived effects of the crisis on elderly patient's access to medicines and medical care, and its implications on medicine-taking behaviour. Setting Community pharmacy. Method A cross-sectional study was undertaken during April 2013, where elderly patients answered a self-administered questionnaire based on their health-related experiences in the current and previous year. Binary logistic regression was used to ascertain the effects of potential predictors on the likelihood of adherence. Main outcome measures self-reported adherence. Results A total of 1231 questionnaires were collected. 27.3% of patients had stopped using treatments or health services in the previous year for financial motives; mostly private medical appointments, followed by dentist appointments. Almost 30% of patients stopped purchasing prescribed medicines. Over 20% of patients reduced their use of public services. Out-of-pocket expenses with medicines were considered higher in the current year by 40.1% of patients. The most common strategy developed to cope with increasing costs of medicines was generic substitution, but around 15% of patients also stopped taking their medication or started saving by increasing the interdose interval. Conclusion Reports of decreasing costs with medicines was associated with a decreased likelihood of adherence (OR 0.42; 95% CI 0.27-0.65). Lower perceived health status and having 3 or more co-morbidities were associated with lower odds of adhering, whilst less frequent medical appointments was associated with a higher likelihood of exhibiting adherence.
- Mobilidade e propagação do sars-cov-2 em Portugal continental: modelo explicativo territorializado em contexto anterior à vacinaçãoPublication . Marques Da Costa, Nuno; Mileu, Nelson; Marques da Costa, Eduarda; Alves, André; Freitas, Carlos; Rocha, Jorge; Abrantes, Patrícia; Gomes, Eduardo; Sousa, Paulo; Campos Fernandes, Adalberto; Gaspar, Rogério; Duarte-Ramos, Filipa; Portugal, RuiA difusão do novo coronavírus tem importantes associações com a mobilidade da população. Recorrendo a modelos de regressão linear múltipla, com informação epidemiológica da Direção-Geral da Saúde (DGS) e dados de mobilidade disponibilizados pela Google, captura-se a relação causal existente entre alterações na mobilidade e a tendência de incidência de COVID-19 para várias escalas em Portugal, demonstrando-se que maior mobilidade está associada a maior número de novos casos. Com base nesta premissa e recorrendo aos padrões de mobilidade da população é possível desenvolver um modelo de previsão do número de infeções futuras, com pelo menos 14 dias de antecedência.
- Optimizing the use of systemic corticosteroids in severe asthma (ROSA II project): a national Delphi consensus studyPublication . Marques, João; Duarte-Ramos, Filipa; Ferreira, Manuel Branco; Lima, Ricardo; Lopes, Cristina; Sokolova, Anna; Tonin, Fernanda Stumpf; Loureiro, Cláudia ChavesAlthough the prevalence of severe asthma is not high (5-10% of patients), it is responsible for a large part of the overall disease burden and costs (50-60% of total costs), especially if the condition remains uncontrolled (which occurs in around 40% of cases). Currently, for patients without disease control or presenting frequent exacerbations despite optimal therapy, add-on treatments, traditionally long-acting anticholinergics, oral corticosteroids (OCS) or biologic agents (monoclonal antibodies) are recommended.2 Nonetheless, the long-term use of oral/systemic corticosteroids (CS) is significantly associated with adverse effects, acute and chronic complications that may decrease health-related quality of life and worsen prognosis, thus requiring additional monitoring and management. Conversely, target therapies (i.e., omalizumab, mepolizumab, reslizumab, benralizumab and more recently, dupilumab) have been developed grounded on the different phenotypes and endotypes of severe asthma, and are gradually reducing the reliance on OCS (i.e., greater specificity for achieving disease control by reducing the risk of exacerbations and requirements for rescue medication and OCS, with limited adverse events).
- Oral hypoglycaemic agentsPublication . Duarte-Ramos, Filipa; Cabrita, Jose
- Prevention of chemotherapy related errors - One step towardPublication . Oliveira, Catarina; Duarte-Ramos, Filipa; Cabrita, Jose
- Prevention of chemotherapy related errors one step towardPublication . Oliveira, Catarina; Duarte-Ramos, Filipa; Cabrita, Jose