Results from a population-based cohort study

Funding Information: We have read the journal's policy and the authors of this manuscript have the following competing interests: ARF reports travel grants from Roche and advisory board fees from Daiichi Sankyo, Gilead, Merck Sharp & Dohme, Novartis and Roche, outside the submitted work. DMB reports travel grants from LEO Farmacêuticos, Merck Sharp & Dohme, Ipsen, Janssen, Roche, and Novartis, advisory board fees from Janssen, Pfizer, Merck Sharp & Dohme, Angelini, AstraZeneca, and Novartis, and institutional grants from F. Hoffmann-La Roche, outside the submitted work. The other authors have declared that no competing interests exist. Funding Information: The authors acknowledge the RON network that cooperated in providing up-to-date information on cases diagnosed and treated with the drug of interest (participating institutions: Centro Hospitalar Universit?rio de S?o Jo?o, Centro Hospitalar Universit?rio Lisboa Norte, Centro Hospitalar Universit?rio do Algarve, Hospital de Braga, Centro Hospitalar e Universit?rio de Coimbra, Centro Hospitalar de Tr?s-os-Montes e Alto Douro, Hospital Central do Funchal, Centro Hospitalar de Vila Nova de Gaia/Espinho, Centro Hospitalar Lisboa Ocidental, Hospital Garcia de Orta, Centro Hospitalar Universit?rio Lisboa Central, Hospital Distrital de Santar?m, Centro Hospitalar de Entre o Douro e Vouga, Hospital da Senhora da Oliveira Guimar?es, Centro Hospitalar de Set?bal, Centro Hospitalar e Universit?rio do Porto, Centro Hospitalar Tondela Viseu, Hospital do Esp?rito Santo de ?vora, Centro Hospitalar Barreiro Montijo, Hospital Beatriz ?ngelo, Hospital do Santo Esp?rito da Ilha Terceira, Hospital do Divino Esp?rito Santo de Ponta Delgada, Hospital Pedro Hispano ? ULS Matosinhos, Hospital do Litoral Alentejano ? Santiago do Cac?m ? ULS Litoral Alentejano, Centro Hospitalar do Oeste, Centro Hospitalar M?dio Tejo, Hospital Jos? Joaquim Fernandes ? Beja ? ULS Baixo Alentejo, Centro Hospitalar Universit?rio da Cova da Beira, Centro Cl?nico Champalimaud, Hospitais CUF, Hospitais da Luz, Hospitais dos Lus?adas, Hospital Particular do Algarve). Publisher Copyright: © 2022 The AuthorsBackground: Real-world (RW) data may provide valuable information on the effectiveness and safety of medicines, which is particularly relevant for clinicians, patients and third-party payers. Evidence on the effectiveness of palbociclib plus fulvestrant is scarce, which highlights the need of additional studies. The aim of this study was to evaluate the effectiveness of palbociclib plus fulvestrant in advanced breast cancer (ABC). Materials and methods: We conducted a population-based retrospective cohort study and cases of interest were identified through the Portuguese National Cancer Registry database and additional data sources. Patients aged≥18 years, diagnosed with ABC and exposed to palbociclib plus fulvestrant between May 31, 2017 and March 31, 2019 were included. Patients were followed-up until death or cut-off date (February 28, 2021). Primary outcome was rw-progression-free survival (rwPFS). Secondary outcomes were rw-overall survival (rwOS), rw-time to palbociclib failure (rwTPF) and rw-time to next treatment (rwTTNT). Results: A total of 210 patients were included. Median age was 58 years (range 29–83) and 99.05% were female. Median follow-up time was 23.22 months and, at cut-off date, treatment had been discontinued in 189 patients, mainly due to disease progression (n = 152). Median rwPFS was 7.43 months (95% confidence interval [CI] 6.28–9.05) and 2-year rwPFS was 16.65% (95%CI 11.97–22.00). Median rwOS was 24.70 months (95%CI 21.58–29.27), median rwTPF was 7.5 months (95%CI 6.51–9.08) and median rwTTNT was 11.74 months (95%CI 10.33–14.08). Conclusion: Palbociclib plus fulvestrant seems an effective treatment for ABC in real-world context. Compared to registrations studies, rwPFS and rwOS were shorter in real-life setting.publishersversionpublishe

A DUALIDADE HOMEM E NATUREZA: uma análise contextualmente situada em ambiência de riscos e incertezas

Pressupondo a contemporaneidade condicionada aos postulados e paradoxos do capitalismo, coloca-se em suspense o paradigma antropocêntrico, investigando as relações entre homem e natureza. Neste sentido, analisam-se o esquecimento do biocentrismo e a multidimensionalidade do direito ao bem-estar e ao futuro. Discutem-se as relações entre desenvolvimento e proteção ambiental em sociedades marcada pela insaciabilidade do consumo. Perscrutam-se as diversas manifestações da desigualdade em sociedades capitalistas. Com base nas categorias da sociologia reflexiva, fez-se uso das técnicas da pesquisa bibliográfica, documental e da análise do discurso. Por fim, algumas considerações representativas da investigação científica em comento.Palavras-chave: Biocentrismo, sustentabilidade, multidimensionalidade.

ANTROPOCENTRISMO E REFUGIADOS AMBIENTAIS

Apresenta-se uma reflexão crítica sobre os caminhos da técnica com destaque para a sua relação com uma economia capitalista que vê na natureza apenas uma fonte de lucro. Analisam-se as relações entre a teoria da sociedade do risco, a formação dos refugiados ambientais e as históricas violências estruturais que demarcam o Brasil Contemporâneo. Por outro lado, a realidade da fauna brasileira e o cenário de violação causado pelo ser humano como uma força geológica prejudicial à preservação dos animais não humanos, têm sido fator que contribui para o agravamento da situação ambiental. Discutem-se as contradições do contrato político quando se trata da proteção dos animais não humanos

One-year mortality after hemodialysis initiation: the prognostic role of the CHA2DS2-VASc Score

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).Background: CKD is a significant cause of morbidity, cardiovascular and all-cause mortality. CHA2DS2-VASc is a score used in patients with atrial fibrillation to predict thromboembolic risk; it also appears to be useful to predict mortality risk. The aim of the study was to evaluate CHA2DS2-VASc scores as a tool for predicting one-year mortality after hemodialysis is started and for identifying factors associated with higher mortality. Methods: Retrospective analysis of patients who started hemodialysis between January 2014 and December 2019 in Centro Hospitalar Universitário Lisboa Norte. We evaluated mortality within one year of hemodialysis initiation. The CHA2DS2-VASc score was calculated at the start of hemodialysis. Results: Of 856 patients analyzed, their mean age was 68.3 ± 15.5 years and the majority were male (61.1%) and Caucasian (84.5%). Mortality within one-year after starting hemodialysis was 17.8% (n = 152). The CHA2DS2-VASc score was significantly higher (4.4 ± 1.7 vs. 3.5 ± 1.8, p < 0.001) in patients who died and satisfactorily predicted the one-year risk of mortality (AUC 0.646, 95% CI 0.6-0.7, p < 0.001), with a sensitivity of 71.7%, a specificity of 49.1%, a positive predictive value of 23.9% and a negative predictive value of 89.2%. In the multivariate analysis, CHA2DS2-VASc ≥3.5 (adjusted HR 2.24 95% CI (1.48-3.37), p < 0.001) and central venous catheter at dialysis initiation (adjusted HR 3.06 95% CI (1.93-4.85)) were significant predictors of one-year mortality. Conclusion: A CHA2DS2-VASc score ≥3.5 and central venous catheter at hemodialysis initiation were predictors of one-year mortality, allowing for risk stratification in hemodialysis patients.info:eu-repo/semantics/publishedVersio

C-reactive protein-to-albumin ratio and six-month mortality in incident hemodialysis patients

© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.Background: The first few months of hemodialysis (HD) are associated with a higher risk of mortality. Protein-energy malnutrition is a demonstrated major risk factor for mortality in this population. The C-Reactive Protein to Albumin ratio (CAR) has also been associated with increased mortality risk. The aim of this study was to determine the predictive value of CAR for six-month mortality in incident HD patients. Methods: Retrospective analysis of incident HD patients between January 2014 and December 2019. CAR was calculated at the start of HD. We analyzed six-month mortality. A Cox regression was performed to predict six-month mortality and the discriminatory ability of CAR was determined using the receiver operating characteristic (ROC) curve. Results: A total of 787 patients were analyzed (mean age 68.34 ± 15.5 years and 60.6% male). The 6-month mortality was 13.8% (n = 109). Patients who died were significantly older (p < 0.001), had more cardiovascular disease (p = 0.010), had central venous catheter at the start of HD (p < 0.001), lower parathyroid hormone (PTH) level (p = 0.014) and higher CAR (p = 0.015). The AUC for mortality prediction was 0.706 (95% CI (0.65-0.76), p < 0.001). The optimal CAR cutoff was ≥0.5, HR 5.36 (95% CI 3.21-8.96, p < 0.001). Conclusion: We demonstrated that higher CAR was significantly associated with a higher mortality risk in the first six months of HD, highlighting the prognostic importance of malnutrition and inflammation in patients starting chronic HD.info:eu-repo/semantics/publishedVersio

CARACTERIZAÇÃO E CORRELAÇÃO ESTATÍSTICA ENTRE AS PROPRIEDADES FÍSICAS E MECÂNICAS DO CARVÃO DE CLONES DE Eucalyptus e Corymbia

The study aimed to analyze the physical and mechanical properties of charcoal from eucalyptus clones by principal component analysis and demonstrate the relationships between these properties, in order to assess which charcoal property should aimed in the process to obtain a higher quality product. In this way, was cut eight clones of Eucalyptus and two of Corymbia, collecting three trees per clone and five disk in different heights. The disks were transformed into test samples, totaling an average of 75 samples per clones, which were carbonized under specific conditions for analysis of apparent density, compressive strength parallel to grain and linear and volumetric degradation due to high temperature. It is noteworthy that the data were weighted by disk and per tree, to an average closer to reality. For correlations, was used multivariate analysis of principal components. Herein, it is found that the apparent density of charcoal acts as the focal point of the other properties studied, and observed that as the higher the density, higher will be the compressive strength parallel to grain, the elastic modulus and the gravimetric yield.O estudo teve como objetivo analisar as propriedades físicas e mecânicas do carvão de clones de eucalipto por análise de componentes principais e demonstrar as correlações entre essas propriedades, a fim de avaliar qual propriedade de carvão deve ser almejada no processo para obter um produto de alta qualidade. Desta forma, foram cortados oito clones de Eucalyptus e dois de Corymbia, coletando três árvores por clone e cinco discos em diferentes alturas. Os discos foram transformados em amostras para ensaio, totalizando uma média de 75 amostras por clones, que foram carbonizados sob condições específicas para a análise da densidade aparente, compressão paralela às fibras e degradação linear e volumétrica devido à alta temperatura. Vale ressaltar que os dados foram ponderados pelo disco e por árvore, para a uma média mais próxima da realidade. Para as correlações, foi utilizada a análise multivariada de componentes principais. Nisto, verificou-se a ação da densidade aparente do carvão como o ponto focal das outras propriedades estudadas e observou-se que quanto maior a densidade, maior será a força de compressão paralela à grã, o módulo de elasticidade e o rendimento gravimétrico

Grupo de Trabalho de Arqueobotânica e Zooarqueologia : resultados da primeira reunião

Resultados da primeira reunião geral de investigadores das áreas científicas da Arqueobotânica e Zooarqueologia a trabalhar em Portugal, realizada em Outubro de 2014, no Museu Nacional de Arqueologia (Lisboa). Identificando um conjunto de dificuldades comuns às duas disciplinas, os presentes decidiram criar um grupo de trabalho informal para fomentar o diálogo profissional e com as instituições universitárias, a tutela (administração central e regional), as empresas e a comunidade arqueológica em geral.Results of the first general meeting of researchers in the fields of Archaeobotany and Zooarchaeology working in Portugal, which took place in October 2014 at the National Museum of Archaeology in Lisbon. Having identified a set of difficulties in common, participants at the meeting decided to set up an informal work group to encourage dialogue among professionals and with universities, central and regional authorities, companies and the archaeological community at large

Score CTo-aBCDE : um novo score preditor de sucesso nas CTOs

© 2020 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L.U. This is an open access article under the CC-BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Introduction: Patient selection for percutaneous coronary intervention (PCI) in chronic total occlusions (CTOs) is crucial to procedural success. Our aim was to identify independent predictors of success in CTO PCI in order to create an accurate score. Methods: In a single-center observational registry of CTO PCI, demographic and clinical data and anatomical characteristics of coronary lesions were recorded. Linear and logistic regression analysis were used to identify predictors of success. A score to predict success was created and its accuracy was measured by receiver operating curve analysis. Results: A total of 377 interventions were performed (334 patients, age 68±11 years, 75% male). The success rate was 65% per patient and 60% per procedure. Predictors of success in univariate analysis were absence of active smoking (OR 2.02, 95% CI 1.243-3.29; p=0.005), presence of tapered stump (OR 5.2, 95% CI 2.7-10.2; p8 with high probability (95%). Conclusion: In our sample only anatomical characteristics were predictors of success. The creation of a score to predict success, with good accuracy, may enable selection of cases that can be treated by any operator, those in which a dedicated operator will be desirable, and those with an extremely low probability of success, which should be considered individually for conservative management, surgical revascularization or PCI by a team experienced in CTO.info:eu-repo/semantics/publishedVersio

Perfil epidemiológico de portadores de marcapasso cardíaco artificial

Objetivo: Conhecer o perfil clínico e epidemiológico de pacientes submetidos a implante de marcapasso definitivo. Métodos: Estudo transversal, retrospectivo e de abordagem quantitativa. Foram analisados 139 prontuários de pacientes submetidos a implante de marcapasso definitivo no ano de 2021 em um hospital de referência em procedimentos cardiovasculares na cidade de Teresina/Piauí. Resultados: Predominou sexo masculino (61,9%), com média de idade de 70 anos. As principais comorbidades foram:&nbsp; hipertensão (79,9%), diabetes mellitus (25,2%) e dislipidemia (14,4%), e os grupos de medicamentos usados, anti-hipertensivos (73,4%), antidiabéticos (14,4%), antidislipidêmicos (17,3%), anticoagulantes (11,5%) e outros (21,6%). As principais indicações para o procedimento de implante de marcapasso definitivo foram: Bloqueio Atrioventricular (81,3%) e Disfunção de Nó Sinusal (15,1%), com manifestações clínicas de tontura (59%), pré-síncope (48,9%) e síncope (40,3%). Evidenciado (0,7%) de complicações nos registros analisados. Conclusão: &nbsp;A pesquisa mostrou a importância do implante de marcapasso definitivo e sua complexidade, pela gravidade dos pacientes indicados, suas comorbidades e fatores de risco, bem como o tipo de patologia que levou à indicação