[Show abstract][Hide abstract] ABSTRACT: A simple and versatile method for the robust attachment of nanocatalytic assemblies on gold surface is developed. To this purpose, carbon disulfide is used to establish a stable linkage between Au (111) surface and magnetite (Fe3O4) nanoparticles, functionalized with metalloporphyrins (Co or Fe) containing carboxylic acids as anchor groups. For comparison purposes the same systems were prepared with gold nanoparticles, which are known to strongly interact with sulfur derivatives. Surface modification is carried out in a one-pot procedure in ethanolic solutions. UV-vis spectra prove the functionalization of the nanoparticles by metalloporphyrins and AFM images reveal the density and size of modified nanoparticles attached to gold by CS2. The efficiency of the immobilization method is demonstrated by the electrochemical performance of the modified electrodes toward oxygen reduction reaction (ORR) in aqueous acidic medium. Koutecky-Levich plots and rotating ring-disk electrode experiments revealed distinct oxygen reduction mechanisms for the nanostructured Co or Fe porphyrin modified electrodes, with the transfer of two or four electrons to form hydrogen peroxide or water, respectively. The chemical nature, composition and size of nanoparticles clearly influence the ORR behavior. The largest magnetite nanoparticles (ca. 40 nm) exhibit the best catalytic response, either modified with iron or cobalt porphyrins. Additionally, electrodes with metalloporphyrin/Fe3O4 nanocatalysts exhibit good stability under acidic conditions. Altogether the results highlight the potentialities of this simple and versatile surface modification for the design of electrocatalytic systems.
[Show abstract][Hide abstract] ABSTRACT: Diffuse alveolar hemorrhage (DAH) is a rare but potentially catastrophic manifestation with a high mortality. Among rheumatologic diseases, it occurs most frequently in patients with systemic lupus erythematosus (SLE) and systemic vasculitis. Despite new diagnostic tools and therapies, it remains a diagnostic and therapeutic challenge. The aim of this work was to characterize the SLE patients with an episode of alveolar hemorrhage followed in our Clinical Immunology Unit (CIU). A retrospective chart review was carried out for all patients with SLE followed in CIU between 1984 and the end of 2013. We reviewed the following data: demographic characteristics, clinical and laboratory data, radiologic investigations, histologic studies, treatment, and outcome. We identified 10 episodes of DAH, corresponding to seven patients, all female. These represent 1.6% of SLE patients followed in our Unit. The age at DAH attack was 42.75 ± 18.9 years. The average time between diagnosis of SLE and the onset of DAH was 7.1 years. Three patients had the diagnosis of SLE and the DAH attack at the same time. Disease activity according to SLEDAI was high, ranging from 15 to 41. All patients were treated with methylprednisolone, 37.5% cyclophosphamide and 28.6% plasmapheresis. The overall mortality rate was 28.6%.
[Show abstract][Hide abstract] ABSTRACT: Background Inflammation is a well-known key component in type 2 diabetes, obesity and cardiovascular disease. It is then expected that patients with chronic inflammatory diseases such as Rheumatoid Arthritis (RA) are at increased riskof metabolic syndrome and its components.
Objectives To define the prevalence of metabolic comorbidities (obesity, diabetes mellitus, hypertension, hypercholesterolemia and hypertriglyceridemia) in RA patients and compare it with its prevalence in the general population; determine predictive factors for metabolic morbidities within these patients.
Methods Retrospective study involving patients with definitive 2010 ACR/EULAR criteria for RA, seen at the outpatient clinic of the Clinical Immunology Unit of the Porto Medical Centre between January and June 2013. Charts were reviewed for baseline demographics, metabolic morbidities profile, time from diagnosis and first consultation, past and present treatments and annual erythrocyte sedimentation rate as a measure of disease activity. The prevalence of metabolic morbidities in the RA cohort was compared with the general population based on the adjusted results of large population based studies for the 2001 Census of Portuguese population. Factors associated with metabolic morbidities were determined by logistic regression analysis; factors univariately associated with the metabolic morbidities (p<0.15) were used to construct the models using a stepwise selection method.
Results We analyzed a random sample of 319 patients with definite criteria for RA; 79.3% were females; the mean age was 57.1 years (±12.8); the median time from diagnosis and first consultation were 4.0 years (IQR 12.0) and 3.4 years (IQR 7.0), respectively. The global prevalence of metabolic morbidities was 51.6% for hypercholesterolemia, 45.5% for hypertension, 23.7% for hypertriglyceridemia, 13.9% for obesity and 12.3% for diabetes. We observed a higher adjusted prevalence of diabetes and hypertension in comparison with the general population (p=0.003 and p<0.001, respectively). We observed positive associations between diabetes mellitus and age (p=0.001) and anti-TNF therapy (p=0.007), between obesity and disease duration (p=0.001) and rituximab therapy (p=0.002), hypercholesterolemia and age (p<0.001), male gender (p=0.024), disease duration (p=0.008) and steroid therapy (p=0.047), between hypertriglyceridemia and sulfasalazine therapy (p=0.017) and between hypertension and age (p<0.001). It was observed a negative association between hypercholesterolemia and azathioprine therapy (p=0.032).
Conclusions We found a high prevalence of metabolic morbidities in our cohort of patients with RA and observed an association between treatment options and some of these morbidities, independently of disease activity
Disclosure of Interest None declared
No preview · Article · Jun 2015 · Annals of the Rheumatic Diseases
[Show abstract][Hide abstract] ABSTRACT: Human leukocyte antigen (HLA)-B*51 is a well-known genetic factor associated with Behçet's disease (BD). To analyse the influence of HLA-B*51 and other HLA class I alleles in BD susceptibility in a Portuguese population and its association with disease severity, we studied 78 BD patients and 208 healthy controls. The patients were classified into two severity groups as described by Gul et al. As expected, a higher frequency of HLA-B*51 was found. The frequency of HLA-Cw*16 alleles was significantly higher in patients. Regarding severity, HLA-B*27 frequency was higher in the severe group compared with controls and with the mild group. Thus, HLA-B*51 and HLA-Cw*16 seem to confer susceptibility to BD in this patients. HLA-B*27 may be important as a prognostic factor.
[Show abstract][Hide abstract] ABSTRACT: Introdução: Os abcessos hepáticos constituem uma entidade clínica pouco frequente que coloca desafios no diagnóstico e tratamento. Nas últimas décadas assistiu-se a mudanças na epidemiologia, avanços nos meios de diagnóstico e ao aparecimento de mais alternativas terapêuticas.
[Show abstract][Hide abstract] ABSTRACT: Background: Behçet Disease (BD) is a rare multisystemic inflammatory disorder of unknown aetiology. Neurological involvement, currently known as Neuro-Behçet (NB) has been reported in the range of 2,2 to 50% in large series. Patients and Methods: From a database of 77 patients with BD, (all fulfilling the International Study Group criteria for the Diagnosis of BD, 1990), we identified 15 patients with Neuro-Behçet disease (NB). Clinical features and neuroimaging data were reviewed. Results: The frequency of NB in our centre was 19,5%. Gender frequency was similar: 8 males, 7 females (M/F: 1,11). HLA-B51 allele was present in 9 of 14 patients tested (64.3%). Mean age at onset of BD and at diagnosis was 29,6 and 34,3 years respectively, and the mean time between the first symptom and the central nervous system (CNS) involvement was 6,2 years. We divided patients in two distinct patterns of first neurological presentation: parenchymal - 9 patients (60%) - brain stem or brainstem plus 67%, hemispheric presentation 33% - and non-parenchymal - 6 patients (40%) - 4 aseptic meningitis, 1 optic neuropathy and 1 dural sinus thrombosis. MRI showed parenchymal lesions in 14 and non-parenchymal lesions in 1 patient. Mean follow-up was 7,8 years; 14 patients had a relapsing-remitting course and one a secondarily progressive course. Two patients were deceased with neurological complications and the others had no major sequels. Conclusion: The frequency of NB in our centre and clinical and neuroimaging features are similar to those reported in other series. Neurological involvement is an important cause of morbidity and mortality in these patients.
[Show abstract][Hide abstract] ABSTRACT: Lupus nephritis (LN) is a frequent and serious manifestation of systemic lupus erythematosus. However, the outcome has progressively improved in the last 3 decades and this was due to more efficient and early treatment of LN and comorbid situations. The aim of our study was to analyze our experience and outcome in LN, to evaluate clinicopathologic and clinicolaboratory correlations and to search for risk factors for renal and patient survival.
We conducted a retrospective study of 78 patients with biopsy-proven LN.
Acute renal failure and subnephrotic proteinuria with microhematuria occurred each one in 39.7% of the patients, nephrotic syndrome in 16.7% and nephritic syndrome in 3.8%. The mean serum creatinine at presentation was 1.45 +/- 1.03 mg/dl and the creatinine clearance was 68.2 +/- 40.3 ml/min. Class IV LN existed in 71.8%, Class III in 20.5%, Class V in 6.4% and Class VI in 1.3%. The treatment included steroids and cytotoxic agents in 87.5% of the patients with proliferative LN. Hypertension, serum creatinine and acute renal failure at presentation, as well as significant chronicity on renal biopsy, were significantly correlated with the progression to chronic renal failure in our population. Males were more prone to develop renal flares. 3.8% of the patients died, 9% lost their renal function, 26.9% are in remission, 33.3% still have subnephrotic proteinuria and microhematuria, 7.7% have nephrotic syndrome and 19.2% have chronic renal failure. The mean global follow-up was 102 +/- 74 months and 96.2% of the patients survived. The actuarial renal survival was 96.1% in the first year; 89.9% at 5 years; and 83.7% at 10 and 20 years.
We can say that hypertension, serum creatinine and acute renal failure at the onset and significant chronicity on renal biopsy, proved to be risk factors for chronic renal failure in our study population. Male gender was a risk factor for renal flares. The achieved global outcome can be considered a good result.
No preview · Article · Mar 2002 · Clinical nephrology
[Show abstract][Hide abstract] ABSTRACT: Uveitis is a general term that refers to the inflammation of uveal tract, which is an important cause of blindness in young people. It is well known that uveitis can be the initial manifestation of a systemic disease (S.D.), and may appear years before the diagnosis of the primary disease. Uveitis should be integrated in a systemic study with proper testing. Therefore, the diagnosis is a matter for the ophthalmologist and the Specialist in internal medicine. We have made a retrospective study of 71 patients with chronic uveitis or panuveitis. We found 54.9% of primary uveitis and 45.1% of S.D. associated uveitis, most of them with Behçet's disease (16/71) and Ankylosing Spondilytis (7/71). HLA typing of the patients showed a decreased frequency of HLA A1 and HLA A3 antigens and an increased frequency of the HLA B27 antigen, when compared to a Portuguese control population. We confirmed the important role of HLA B27 as an independent susceptibility factor for anterior uveitis. The lowest HLA A3 frequency was observed in the group of S.D. associated uveitis, which could suggest that this antigen may play a role as a factor of resistance to uveitis.
No preview · Article · Nov 1998 · Acta médica portuguesa
[Show abstract][Hide abstract] ABSTRACT: We report a case of a 23 year-old man admitted to hospital with cough, fever and recurrent episodes of haemoptysis. Laboratory findings, which included a pulmonary biopsy, established the diagnosis of Idiophatic Pulmonary Hemosiderosis (IPH). Despite a number of morphologic, immunologic and ultrastructural studies, the etiology and pathogenesis of this disease remain indetermined. To diagnose an IPH all the other causes of pulmonary hemorrhage must be excluded. This is a rare disease, even more rare in adults. Based on these facts the authors publish this article, which includes the case report and a literature review.
No preview · Article · Feb 1996 · Acta médica portuguesa