المؤلفون: Cysneiros, Ana, Galvão, Tiago, Domingues, Nuno, Jorge, Pedro, Bento, Luis, Martin-Loeches, Ignacio

المساهمون: NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)

مصطلحات موضوعية: ARDS, deep learning, imaging, machine learning, Medicine (miscellaneous), Biochemistry, Genetics and Molecular Biology(all)

الوصف: Funding Information: This research was partially funded by Predictive Models of COVID-19 Outcomes for Higher Risk Patients Towards Precision Medicine (PREMO) project, by Fundação para a Ciência e Tecnologia (FCT) grant DSAIPA/DS/0117/2020. Publisher Copyright: © 2024 by the authors. ; Introduction: Within primary ARDS, SARS-CoV-2-associated ARDS (C-ARDS) emerged in late 2019, reaching its peak during the subsequent two years. Recent efforts in ARDS research have concentrated on phenotyping this heterogeneous syndrome to enhance comprehension of its pathophysiology. Methods and Results: A retrospective study was conducted on C-ARDS patients from April 2020 to February 2021, encompassing 110 participants with a mean age of 63.2 ± 11.92 (26–83 years). Of these, 61.2% (68) were male, and 25% (17) experienced severe ARDS, resulting in a mortality rate of 47.3% (52). Ventilation settings, arterial blood gases, and chest X-ray (CXR) were evaluated on the first day of invasive mechanical ventilation and between days two and three. CXR images were scrutinized using a convolutional neural network (CNN). A binary logistic regression model for predicting C-ARDS mortality was developed based on the most influential variables: age, PaO2/FiO2 ratio (P/F) on days one and three, CNN-extracted CXR features, and age. Initial performance assessment on test data (23 patients out of the 110) revealed an area under the receiver operating characteristic (ROC) curve of 0.862 with a 95% confidence interval (0.654–0.969). Conclusion: Integrating data available in all intensive care units enables the prediction of C-ARDS mortality by utilizing evolving P/F ratios and CXR. This approach can assist in tailoring treatment plans and initiating early discussions to escalate care and extracorporeal life support. Machine learning algorithms for imaging classification can uncover otherwise inaccessible patterns, potentially evolving into another form of ARDS phenotyping. The combined features of these algorithms and clinical variables demonstrate ...

العلاقة: PURE: 86125946; PURE UUID: 4b11b3b0-3ce5-4a41-9572-2fd754419bdf; Scopus: 85187260149; http://hdl.handle.net/10362/166068Test; https://doi.org/10.3390/biomedicines12020439Test

الإتاحة: https://doi.org/10.3390/biomedicines12020439Test
http://hdl.handle.net/10362/166068Test

المؤلفون: Domingues, Neuza, Gaifem, Joana, Matthiesen, Rune, Saraiva, Diana P., Bento, Luís, Marques, André R.A., Soares, Maria I.L., Sampaio, Julio, Klose, Christian, Surma, Michal A., Almeida, Manuel S., Rodrigues, Gustavo, Gonçalves, Pedro Araújo, Ferreira, Jorge, Melo, Ryan Gouveiae, Pedro, Luís Mendes, Simons, Kai, Pinho e Melo, Teresa M.V.D., Guadalupe Cabral, M., Jacinto, Antonio, Silvestre, Ricardo, Vaz, Winchil, Vieira, Otília V.

المساهمون: NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), iNOVA4Health - pólo NMS

مصطلحات موضوعية: atherosclerosis, cholesteryl hemiazelates, cholesteryl hemiesters, innate inflammatory responses, lipidomics, Biochemistry, Endocrinology, Cell Biology, SDG 3 - Good Health and Well-being

الوصف: Funding Information: supported by FCT through projects UIDB/00313/2020 and UIDP/00313/2020. Funding Information: R. S. group has been funded by national funds, through the FCT—project numbers UIDB/50026/2020 and UIDP/ 50026/2020 and 2020.00185. CEECIND to the FCT. Funding Information: N. D. was a holder of a PhD fellowship from the FCT (Ref. N◦: SFRH/BD/51877/2012). Funding Information: The authors acknowledge the technical support of the Microscopy and Fish Facilities NOVA Medical School. They also acknowledge the UC-NMR facility for obtaining the NMR data (http://www.nmrccc.uc.ptTest). This work was also supported by the Biobanco-iMM, Lisbon Academic Medical Center, Lisbon, Portugal. This work was financially supported by the Foundation for Science and Technology (FCT) of the Portuguese Ministry of Science and Higher Education through national funds, project reference: 2022.01305.PTDC. The Coimbra Chemistry Centre is Fig. 7. Working model of the proatherogenic properties of ChA. ChA is an end product of cholesteryl linoleate oxidation, generated in the arterial intima. Because of its amphiphilic properties, ChA can be detected in the plasma of CVD patients. The presence of ChA in circulation can imprint an inflammatory phenotype in the circulating monocytes and neutrophils (1), conditioning the immunological response in the arterial intima. ChA promotes the recruitment of innate immune cells, neutrophils, and monocytes into the vasculature (2). Here, neutrophils in the presence of ChA secret IL-1β, which can interfere with monocyte/ macrophage priming. Monocytes differentiated in the presence of ChA are activated, increasing the secretion of inflammatory cytokines: IL-1β, IL-6, and IL-10 (3). In activated macrophages, ChA induces lipid accumulation (foam cells) and lysosomal dysfunction, conferring then the second signal necessary for IL-1β secretion mediated by inflammasome activation (4). IL-1β can initiate a propagation loop of the inflammation, increasing the macrophage secretion of IL-6 and TNF-α. On the ...

العلاقة: PURE: 72963233; PURE UUID: eef09792-8582-4504-a292-51bbe56ff47e; Scopus: 85171672894; PubMed: 37482218; ORCID: /0000-0002-4193-6089/work/151385798; WOS: 001098532700001; http://hdl.handle.net/10362/158604Test; https://doi.org/10.1016/j.jlr.2023.100419Test

الإتاحة: https://doi.org/10.1016/j.jlr.2023.100419Test
http://hdl.handle.net/10362/158604Test

المؤلفون: Domingues, Neuza, Gaifem, Joana, Matthiesen, Rune, Saraiva, Diana P., Bento, Luís, Marques, André R.A., Soares, Maria I.L., Sampaio, Julio, Klose, Christian, Surma, Michal A., Almeida, Manuel S., Rodrigues, Gustavo, Gonçalves, Pedro Araújo, Ferreira, Jorge, e Melo, Ryan Gouveia, Pedro, Luís Mendes, Simons, Kai, Pinho e Melo, Teresa M.V.D., Cabral, M. Guadalupe, Jacinto, Antonio, Silvestre, Ricardo, Vaz, Winchil, Vieira, Otília V.

المساهمون: Foundation for Science and Technology, Ministério da Ciência, Tecnologia e Ensino Superior, European Regional Development Fund

المصدر: Journal of Lipid Research ; volume 64, issue 9, page 100419 ; ISSN 0022-2275

مصطلحات موضوعية: Cell Biology, Endocrinology, Biochemistry

الإتاحة: https://doi.org/10.1016/j.jlr.2023.100419Test
https://api.elsevier.com/content/article/PII:S0022227523000925?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0022227523000925?httpAccept=text/plainTest

المؤلفون: Araújo, Rúben, Bento, Luís F.N., Fonseca, Tiago A.H., Von Rekowski, Cristiana P., da Cunha, Bernardo Ribeiro, Calado, Cecília R.C.

المساهمون: NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), Centro de Estudos de Doenças Crónicas (CEDOC), Comprehensive Health Research Centre (CHRC) - pólo NMS

مصطلحات موضوعية: Biomarkers, Diagnosis, Infection, Metabolomics, Prognosis, Endocrinology, Diabetes and Metabolism, Biochemistry, Molecular Biology, SDG 3 - Good Health and Well-being

الوصف: Funding Information: Funding: This work was supported by the project grant DSAIPA/DS/0117/2020 supported by Fundação para a Ciência e a Tecnologia, Portugal; and by the project grant NeproMD/ISEL/2020 financed by Instituto Politécnico de Lisboa. ; Current infection biomarkers are highly limited since they have low capability to predict infection in the presence of confounding processes such as in non-infectious inflammatory processes, low capability to predict disease outcomes and have limited applications to guide and evaluate therapeutic regimes. Therefore, it is critical to discover and develop new and effective clinical infection biomarkers, especially applicable in patients at risk of developing severe illness and critically ill patients. Ideal biomarkers would effectively help physicians with better patient management, leading to a decrease of severe outcomes, personalize therapies, minimize antibiotics overuse and hospitalization time, and significantly improve patient survival. Metabolomics, by providing a direct insight into the functional metabolic outcome of an organism, presents a highly appealing strategy to discover these biomarkers. The present work reviews the desired main characteristics of infection biomarkers, the main metabolomics strategies to discover these biomarkers and the next steps for developing the area towards effective clinical biomarkers. ; publishersversion ; published

العلاقة: PURE: 41735513; PURE UUID: c08eb9f4-93d6-4a5e-b4a6-c389d2bd7a78; Scopus: 85124153058; WOS: 000772043100001; http://hdl.handle.net/10362/133482Test; https://doi.org/10.3390/metabo12020092Test

الإتاحة: https://doi.org/10.3390/metabo12020092Test
http://hdl.handle.net/10362/133482Test

المؤلفون: Gonçalves-Pereira, João, Oliveira, Bruno Serra, Janeiro, Sérgio, Estilita, Joana, Monteiro, Catarina, Salgueiro, Andrea, Vieira, Alfredo, Gouveia, Joao, Paulino, Carolina, Bento, Luis, Póvoa, Pedro

المساهمون: NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), Centro de Estudos de Doenças Crónicas (CEDOC)

مصطلحات موضوعية: CARE-UNIT PATIENTS, INTENSIVE-CARE, CONTROLLED-TRIALS, BETA-LACTAMS, ANTIBIOTICS, CEFEPIME, CLEARANCE, PHARMACOKINETICS, METAANALYSIS, TAZOBACTAM, Agricultural and Biological Sciences(all), Biochemistry, Genetics and Molecular Biology(all), Medicine(all)

الوصف: The clinical efficacy of continuous infusion of piperacillin/tazobactam in critically ill patients with microbiologically documented infections is currently unknown. We conducted a retrospective multicenter cohort study in 7 Portuguese intensive care units (ICU). We included 569 critically ill adult patients with a documented infection and treated with piperacillin/tazobactam admitted to one of the participating ICU between 2006 and 2010. We successfully matched 173 pairs of patients according to whether they received continuous or conventional intermittent dosing of piperacillin/tazobactam, using a propensity score to adjust for confounding variables. The majority of patients received 16g/day of piperacillin plus 2g/day of tazobactam. The 28-day mortality rate was 28.3% in both groups (p = 1.0). The ICU and in-hospital mortality were also similar either in those receiving continuous infusion or intermittent dosing (23.7% vs. 20.2%, p = 0.512 and 41.6% vs. 40.5%, p = 0.913, respectively). In the subgroup of patients with a Simplified Acute Physiology Score (SAPS) II>42, the 28-day mortality rate was lower in the continuous infusion group (31.4% vs. 35.2%) although not reaching significance (p = 0.66). We concluded that the clinical efficacy of piperacillin/tazobactam in this heterogeneous group of critically ill patients infected with susceptible bacteria was independent of its mode of administration, either continuous infusion or intermittent dosing. ; publishersversion ; published

العلاقة: PURE: 2991230; PURE UUID: f1799039-a760-492f-bd39-6e496c9a13f3; Scopus: 84869853144; PubMed: 23185458; WOS: 000311821000123; http://www.scopus.com/inward/record.url?scp=84869853144&partnerID=8YFLogxKTest; https://doi.org/10.1371/journal.pone.0049845Test

الإتاحة: https://doi.org/10.1371/journal.pone.0049845Test
http://www.scopus.com/inward/record.url?scp=84869853144&partnerID=8YFLogxKTest