Behavioural patterns in allergic rhinitis medication in Europe: A study using MASK-air® real-world data

Artículo escrito por un elevado número de autores, solo se referencian el que aparece en primer lugar, el nombre del grupo de colaboración, si le hubiere, y los autores pertenecientes a la UAMBackground: Co-medication is common among patients with allergic rhinitis (AR), but its dimension and patterns are unknown. This is particularly relevant since AR is understood differently across European countries, as reflected by rhinitis-related search patterns in Google Trends. This study aims to assess AR co-medication and its regional patterns in Europe, using real-world data. Methods: We analysed 2015–2020 MASK-air® European data. We compared days under no medication, monotherapy and co-medication using the visual analogue scale (VAS) levels for overall allergic symptoms (‘VAS Global Symptoms’) and impact of AR on work. We assessed the monthly use of different medication schemes, performing separate analyses by region (defined geographically or by Google Trends patterns). We estimated the average number of different drugs reported per patient within 1 year. Results: We analysed 222,024 days (13,122 users), including 63,887 days (28.8%) under monotherapy and 38,315 (17.3%) under co-medication. The median ‘VAS Global Symptoms’ was 7 for no medication days, 14 for monotherapy and 21 for co-medication (p <.001). Medication use peaked during the spring, with similar patterns across different European regions (defined geographically or by Google Trends). Oral H1-antihistamines were the most common medication in single and co-medication. Each patient reported using an annual average of 2.7 drugs, with 80% reporting two or more. Conclusions: Allergic rhinitis medication patterns are similar across European regions. One third of treatment days involved co-medication. These findings suggest that patients treat themselves according to their symptoms (irrespective of how they understand AR) and that co-medication use is driven by symptom severityThis study was funded by ARIA. MASK-air® has been supported by EU grants (EU Structural and Development grant, POLLAR: EIT Health and Structural and Development Funds) and educational grants from Mylan-Viatris, ALK, GSK, Novartis and Uriach. Open Access funding enabled and organized by Projekt DEA

Where do we stand with asthma phenotypes derived from data-driven methods? A systematic review

Asthma phenotypes can be refined using methods without a priori assumptions (data-driven). We aimed to describe asthma phenotypes derived with data-driven methods, using variables easily measurable in a clinical setting, and to summarize their consistency.info:eu-repo/semantics/publishedVersio

Modulação terapêutica das células percursoras do endotélio por anti-hipertensores

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2018A medula óssea contém um subtipo particular de células progenitoras com capacidade para se diferenciarem em células endoteliais. As células percursoras de endotélio (EPCs) desempenham um papel-chave na manutenção da homeostasia endotelial e promovem a reparação vascular. A concentração normal de EPCs em circulação é considerada um marcador de saúde vascular. O papel das EPCs na biologia vascular começa a ser melhor caracterizado, no entanto a sua função na hipertensão arterial (HTA) encontra-se ainda incompletamente estudada. Nomeadamente, os efeitos da terapêutica anti-hipertensora na biologia das próprias EPCs permanece pouco caracterizado. Partindo destas premissas, nesta revisão sistematizada foi realizada uma pesquisa no PUBMED escrutinando a associação entre EPCs e o nome de classes de anti- hipertensores. Foram obtidos 181 artigos e após aplicação de critérios de elegibilidade foram selecionados 23 artigos, 4 dos quais excluídos após segunda revisão do artigo completo. Classes como os inibidores da enzima de conversão da angiotensina, os antagonistas dos recetores da angiotensina II e os bloqueadores dos canais de cálcio demonstraram aumentar o número e a capacidade funcional das EPCs (mobilização, proliferação, diminuição da apoptose, resistência ao stress oxidativo e capacidade formadora de colónias). Já os diuréticos e os bloqueadores beta-adrenérgicos parecem não ter efeito modulador benéfico neste âmbito. Os nitratos orgânicos apresentam um efeito intermédio, dependendo do fármaco em questão. Serão necessários, mais estudos, com critérios metodológicos mais homogéneos para confirmar as observações supracitadas, podendo vir futuramente a serem aplicados eventuais protocolos de atuação terapêutica, tendo em consideração os efeitos pleiotrópicos destas células.Bone marrow contains a particular subtype of progenitor cells capable of differentiating into endothelial cells. Endothelial precursor cells (EPCs) play a key role in maintaining endothelial homeostasis and promote vascular repair. The normal concentration of circulating EPCs is a vascular health marker. The role of EPCs in vascular biology begins to be better characterized, however its role in arterial hypertension (AHT) is still incompletely studied. Notably, the effects of antihypertensive therapy on the biology of EPCs themselves remain poorly characterized. Based on these premises, in this systematized review a research was done in the PUBMED scrutinizing the association between EPCs and the name of antihypertensive classes. 181 articles were obtained and after application of eligibility criteria, 23 articles were selected, 4 of which were excluded after a second review of the complete article. Classes such as angiotensin converting enzyme inhibitors, angiotensin II receptor antagonists and calcium channel blockers have demonstrated increased functional capacity of EPCs (mobilization, proliferation, increased apoptosis, resistance to oxidative stress and formative capacity of colonies). Diuretics and beta-adrenergic blockers, however, do not appear to have a beneficial modulatory effect in this context. Nitrates should have an intermediate effect depending on the drug in question. Further studies will be needed with more homogeneous methodological criteria to confirm the observations mentioned above, and future protocols for therapeutic action may be applied in future, taking into account the pleiotropic effects of these cells

Será que o perfil académico e científico dos ministros e secretários de estado da saúde europeus importa para um processo de decisão informado?

ABSTRACT - Background: The impact of health politicians’ qualifications on healthcare quality has not been widely studied. Objectives: To assess whether academic qualifications and scientific output of European health decision makers correlate with healthcare quality, as well as with other developmental and scientific indices. Methods: We assessed the academic qualifications and scientific output of health ministers and state secretaries of EU member states. Based on the highest academic degree held, we created an academic score for each politician, and calculated the average academic score of each country’s health politicians. Associations between the average academic score and public perception of healthcare quality and other developmental and scientific variables were tested by means of simple and multiple linear regression models. Results: Half of the politicians held qualifications in the field of health, followed by economics and management (37%) and social sciences (35%). Over the last 10 years, 28% politicians had authored publications indexed in Web of ScienceTM, mostly in the field of health. The average academic score of health European politicians was negatively correlated with both public perception of healthcare quality (ρ = –0.473; p = 0.011) and with countries’ gross domestic product (GDP) per capita (ρ = –0.664; p < 0.001). In a multiple linear regression model, the GDP per capita was independently and negatively associated with the average academic score (p = 0.038), but the same was not observed for the public perception of healthcare quality (p = 0.722). Conclusions: While correlation does not imply causation, in European countries with higher GDP per capita, health politicians tend to be less qualified.RESUMO - Contexto: O impacto das qualificações académicas dos decisores políticos em saúde não foi ainda amplamente estudado. Objectivos: Avaliar se o perfil académico e científico dos decisores em saúde europeus se relaciona com a qualidade de prestação de cuidados de saúde, bem como com outros índices de desenvolvimento e científicos. Métodos: Efectuámos um levantamento das qualificações académicas e da produção científica dos ministros da saúde e respectivos secretários de estado dos Estadosmembros da União Europeia. Partindo do grau académico mais elevado alcançado, construiu-se um score académico para cada político e calculou-se o score académico médio para cada país. Foram construídos modelos de regressão linear para avaliar associações entre o score académico médio e a percepção pública da qualidade da prestação de cuidados de saúde e outras variáveis de desenvolvimento e científicas. Resultados: Metade dos políticos apresentavam qualificações académicas na área da saúde, seguindo-se economia e gestão (37%), e ciências sociais (35%). Nos últimos 10 anos, 28% dos políticos publicaram em revistas indexadas na Web of ScienceTM, a maioria na área da saúde. O score académico médio dos políticos Europeus em saúde correlaciona-se negativamente quer com a percepção pública da qualidade dos cuidados de saúde prestados (ρ = –0.473; p = 0.011) quer com o Produto Interno Bruto (PIB) per capita (ρ = –0.664; p < 0.001) do respectivo país. No modelo de regressão linear múltipla, o PIB per capita demonstrou uma associação negativa independente com o score académico médio (p = 0.038), mas o mesmo não foi observado para a percepção pública da qualidade da prestação de cuidados de saúde (p = 0.722). Conclusões: Embora correlação não implique causalidade, nos países Europeus com PIB per capita mais elevado, os decisores políticos em saúde tendem a apresentar menos qualificações académicas.info:eu-repo/semantics/publishedVersio

Assertion-based slicing and slice graphs

This paper revisits the idea of slicing programs based on their axiomatic semantics, rather than using criteria based on control/data dependencies. We show how the forward propagation of preconditions and the backward propagation of postconditions can be combined in a new slicing algorithm that is more precise than the existing specification-based algorithms. The algorithm is based on (i) a precise test for removable statements, and (ii) the construction of a \emph{slice graph}, a program control flow graph extended with semantic labels and additional edges that ``short-circuit'' removable commands. It improves on previous approaches in two aspects: it does not fail to identify removable commands; and it produces the smallest possible slice that can be obtained (in a sense that will be made precise). Iteration is handled through the use of loop invariants and variants to ensure termination. The paper also discusses in detail applications of these forms of slicing, including the elimination of (conditionally) unreachable and dead code, and compares them to other related notions.Fundação para a Ciência e a Tecnologia (FCT

Assertion-based slicing and slice graphs

© 2010 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other works.This paper revisits the idea of slicing programs based on their axiomatic semantics, rather than using criteria based on control/data dependencies. We show how the forward propagation of preconditions and the backward propagation of post conditions can be combined in a new slicing algorithm that is more precise than the existing specification-based algorithms. The algorithm is based on (i) a precise test for removable statements, and (ii) the construction of a slice graph, a program control flow graph extended with semantic labels. It improves on previous approaches in two aspects: it does not fail to identify removable commands; and it produces the smallest possible slice that can be obtained (in a sense that will be made precise). The paper also reviews in detail, through examples, the ideas behind the use of preconditions and post conditions for slicing programs.Fundação para a Ciência e a Tecnologia (FCT) - RESCUE (PTDC/EIA/65862/2006)

Oral health effects of botulinum toxin treatment for drooling:a systematic review

Drooling is a major morbidity in several neurological diseases. Intraglandular botulinum neurotoxin (BoNT) injections have been used to manage this condition. However, by decreasing salivary flow, BoNT injections may result in an increased risk of caries and other oral adverse effects. In this study, we aimed to assess whether, in patients with drooling, intraglandular BoNT injections are associated with increased dental caries development, modifications on salivary composition (oral pH, buffering capacity and osmolality) and cariogenic bacterial load. We performed a systematic review, searching PubMed, CENTRAL, Web of Science, and Scopus for all experimental and observational studies reporting on adverse effects of intraglandular BoNT injections in patients with drooling. Primary study selection, quality assessment, and data extraction were independently performed by two researchers. No studies were excluded based on their language, publication status or date of publication. Studies? quality was based on revised Cochrane Risk of Bias tools. Meta-analysis was not performed. We retrieved 1025 studies, of which 5 were included. Two studies were two randomized controlled trials and three quasi-experimental studies. None of the included studies found BoNT injections to be associated with dental caries development or with significant reductions in oral pH. One of the included primary studies even observed an increase in salivary buffer capacity. One study found an increase in Lactobacilli counts. As for the risk of bias, two studies were classified as having a critical risk, two as high risk and one as having some concerns. Currently, there is no evidence that, in patients with drooling, BoNT injections associate with increased risk of dental caries or disturbances in oral pH or salivary buffering capacity. However, the included primary studies had important limitations and differences in their methodologies

Bleb morphology of glaucoma drainage devices on magnetic resonance imaging

© 2023 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.Purpose: To evaluate bleb morphology features of different glaucoma drainage devices (GDD) using magnetic resonance imaging (MRI). Materials and methods: Prospective cohort study of GDD and bleb morphology in consecutive glaucoma patients implanted with Ahmed Glaucoma Valve (AGV), Paul Glaucoma Implant (PGI), Baerveldt Glaucoma Implant (BGI) and Ahmed ClearPath (ACP) devices. Thirty-six eyes from 30 consecutive patients underwent standardized GDD implantation followed by MRI at least 1 month after surgery. Main outcomes included bleb volume and endplate position relative to the optic nerve. Secondary outcomes included intraocular pressure (IOP), medication and surgical complications during a 12-month follow-up. Results: Seven eyes were implanted with the AGV (19%), 5 with BGI (14%), 16 with PGI (44%) and 8 with ACP (22%). MRI scans were obtained 85 ± 66 days after surgery. Mean total bleb volume was 563 ± 390 mm3 . This bleb volume was inversely correlated with early post-operative IOP (day 7; rs = -0.3326, p = 0.0475) but positively correlated with IOP at 12 months (rs = 0.3592, p = 0.0341). No significant difference in total bleb volume was found between GDD types (p = 0.1223). A double-layered bleb was observed in 34 eyes (94%). The inferior bleb volume was significantly larger in PGI devices versus other GDD types (380 ± 205 vs. 193 ± 161 mm3 ; p = 0.0043). Distance from the endplate to the optic nerve was 9.5 ± 4.0 mm, similar across GDDs (p = 0.2519). Conclusions: Double-layered blebs are a common finding with GDDs. Bleb volume showed different correlations with IOP at distinct timepoints and the PGI device formed larger blebs. A standardized GDD implantation technique ensures a safe distance from the GDD endplate to the optic nerve.info:eu-repo/semantics/publishedVersio