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Article ; Online: A comprehensive review on PFAS including survey results from the EFLM Member Societies.

Ozben, Tomris / Fragão-Marques, Mariana / Tomasi, Aldo

Clinical chemistry and laboratory medicine

2024 Volume 62, Issue 6, Page(s) 1070–1079

Abstract: Objectives: Per- and polyfluoroalkyl substances (PFASs) are a large class of synthetic chemicals widely used for their unique properties. Without PFAS, many medical device and : Methods: A survey was conducted in March 2023 to collect information on ... ...

Abstract	Objectives: Per- and polyfluoroalkyl substances (PFASs) are a large class of synthetic chemicals widely used for their unique properties. Without PFAS, many medical device and Methods: A survey was conducted in March 2023 to collect information on the potential emission and end-of-life of PFAS-containing medical technologies in the medical laboratories of the EFLM member societies. A series of questions were presented to the EFLM national societies and the results were documented. Results: Eight respondents participated in the survey, representing EFLM member societies in seven different countries including hospital laboratories, university laboratories, and private laboratories. Conclusions: PFAS uses in MD and IVD are influenced by several factors, including evolving regulations, advances in technology, safety and efficacy of these substances. Advancements in analytical techniques may lead to more sensitive and precise methods for detecting and quantifying PFAS in biological samples, which can be essential for IVD applications related to biomarker analysis and disease diagnosis. Collaboration among regulatory agencies, industry, research institutions, hospitals, and laboratories on a global scale can aid in establishing harmonized guidelines and standards for the use of PFAS, ensuring consistency and safety within their applications.
MeSH term(s)	Fluorocarbons/analysis ; Humans ; Surveys and Questionnaires
Chemical Substances	Fluorocarbons
Language	English
Publishing date	2024-01-29
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	1418007-8
ISSN	1437-4331 ; 1434-6621 ; 1437-8523
ISSN (online)	1437-4331
ISSN	1434-6621 ; 1437-8523
DOI	10.1515/cclm-2023-1418
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Zs.A 121: Show issues

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Article ; Online: Digital transformation and sustainability in healthcare and clinical laboratories.

Fragão-Marques, Mariana / Ozben, Tomris

Clinical chemistry and laboratory medicine

2022 Volume 61, Issue 4, Page(s) 627–633

Abstract: Healthcare, and in particular, clinical laboratories, are major contributors to carbon emissions and waste. Sustainability in healthcare has shifted from an environmental concern towards a holistic definition that includes balancing socio-ecological and ... ...

Abstract	Healthcare, and in particular, clinical laboratories, are major contributors to carbon emissions and waste. Sustainability in healthcare has shifted from an environmental concern towards a holistic definition that includes balancing socio-ecological and socio-technical systems, including health services effectiveness and cost efficiency. Digital transformation can reduce waste and the cost of services by enhancing effectiveness while maintaining quality. Digital health interventions can provide personalized patient-centered care on a global scale and include decision support systems that have the potential to improve the performance and quality of healthcare. The right interfaces must be used so that the advantages of going digital are felt throughout the health system: a successful and sustainable implementation of digital innovation depends on its integration into a functional health ecosystem. Telehealth has the potential to reduce carbon emissions due to the reduced daily commute of health professionals, although research is limited. Recently, economic models have changed from the linear "take-make-dispose" to circular models based on recycling and upcycling that have the goal of keeping products, components, and materials at their highest utility and value. The previous linear models threaten human health and well-being and harm natural ecosystems.
MeSH term(s)	Humans ; Ecosystem ; Laboratories, Clinical ; Delivery of Health Care ; Telemedicine
Language	English
Publishing date	2022-12-06
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1418007-8
ISSN	1437-4331 ; 1434-6621 ; 1437-8523
ISSN (online)	1437-4331
ISSN	1434-6621 ; 1437-8523
DOI	10.1515/cclm-2022-1092
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Zs.A 121: Show issues

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Article ; Online: Chemical strategies for sustainable medical laboratories.

Ozben, Tomris / Fragão-Marques, Mariana

Clinical chemistry and laboratory medicine

2022 Volume 61, Issue 4, Page(s) 642–650

Abstract: Chemicals are essential components of our daily lives, for the well-being, high living standards and comfort of modern society. They are used in many sectors, including health. However, some chemicals have hazardous properties which can harm the ... ...

Abstract	Chemicals are essential components of our daily lives, for the well-being, high living standards and comfort of modern society. They are used in many sectors, including health. However, some chemicals have hazardous properties which can harm the environment and human health. Chemical pollution is significantly contributing to the current global problem of climate change and loss of biodiversity There is an increase in health problems that can be partially explained by the use of chemicals. Some man-made chemicals are found in the most remote places in the environment, but also in our bodies. Chemicals are everywhere. Chemicals strategy for sustainability towards a toxic-free environment will ensure better protection of human health and the environment from hazardous chemicals, boost innovation for safe and sustainable chemicals and enable the transition to chemicals that are safe and sustainable by design. It is a first step towards the Zero pollution ambition for a toxic-free environment announced in the European Green Deal. The strategy proposes comprehensive chemical legislations for the transformation of industry with the aim of attracting investment into safe and sustainable products and production methods. Clinical laboratories must choose safer, more sustainable alternatives to hazardous chemicals, address sustainability issues, and implement official guidelines on how to reduce their carbon footprint.
MeSH term(s)	Humans ; Laboratories ; Environmental Pollution/prevention & control ; Hazardous Substances
Chemical Substances	Hazardous Substances
Language	English
Publishing date	2022-12-22
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	1418007-8
ISSN	1437-4331 ; 1434-6621 ; 1437-8523
ISSN (online)	1437-4331
ISSN	1434-6621 ; 1437-8523
DOI	10.1515/cclm-2022-1157
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Zs.A 121: Show issues

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Article ; Online: Response to the Letter "Mean Platelet Volume May Not Predict Restenosis after Carotid Endarterectomy" from Beyan C. and Beyan E.

Fragão-Marques, Mariana / Rocha-Neves, João / Andrade, José P

Annals of vascular surgery

2022 Volume 83, Page(s) e6–e7

MeSH term(s)	Carotid Stenosis/diagnostic imaging ; Carotid Stenosis/surgery ; Constriction, Pathologic ; Endarterectomy, Carotid/adverse effects ; Humans ; Mean Platelet Volume ; Treatment Outcome
Language	English
Publishing date	2022-03-23
Publishing country	Netherlands
Document type	Letter ; Comment
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2022.03.004
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Zs.A 2882: Show issues

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Article ; Online: Tranexamic acid in total shoulder arthroplasty under regional anesthesia: a randomized, single blinded, controlled trial.

Garcia, Teresa / Fragão-Marques, Mariana / Pimentão, Pedro / Pinto, Martim / Pedro, Inês / Martins, Carlos

Brazilian journal of anesthesiology (Elsevier)

2021 Volume 72, Issue 2, Page(s) 220–227

Abstract: Purpose: The purpose of this study was to determine whether Tranexamic Acid (TXA) can significantly reduce perioperative blood loss in Total Shoulder Arthroplasty (TSA) performed under regional anesthesia.: Methods: We performed a randomized, single ... ...

Abstract	Purpose: The purpose of this study was to determine whether Tranexamic Acid (TXA) can significantly reduce perioperative blood loss in Total Shoulder Arthroplasty (TSA) performed under regional anesthesia. Methods: We performed a randomized, single blinded, controlled study. Forty-five patients were submitted to TSA under regional anesthesia to treat cuff tear arthropathy, proximal humeral fractures, chronic instability, primary osteoarthrosis, and failures of previous prosthesis. Patients were randomized to either group TXA therapy (TXA), with 1 g intravenous (IV), or no Intervention (NTXA). Postoperative total drain output, hemoglobin variation, total blood loss, hemoglobin loss, and need for transfusion were measured. Pain-related variables were also assessed: postoperative pain assessment by visual analog scale, inpatient pain breakthrough, quality of recovery, length of stay, and coagulation function testing. Results: Participants presented a mean age of 76 years, 15.6% were male, 82.2% were American Society of Anesthesiologists (ASA) physical status I or II. There were no differences between groups concerning transfusions, operative time, Post-Anesthesia Care Unit (PACU) length of stay and in-hospital stay, and QoR-15 or postoperative pain. Bleeding measured by drain output at 2, 24 and 48 hours was significantly less in the TXA group at each timepoint. There was a difference in Hb variation - TXA: median (IQR) -1.4 (1.3) g.dL Conclusion: TXA use significantly decreased blood loss measured by drain output and Hb drop in TSA under regional anesthesia.
MeSH term(s)	Administration, Intravenous ; Aged ; Anesthesia, Conduction ; Antifibrinolytic Agents/therapeutic use ; Arthroplasty, Replacement, Shoulder ; Blood Loss, Surgical/prevention & control ; Hemoglobins ; Humans ; Male ; Pain, Postoperative/drug therapy ; Tranexamic Acid/therapeutic use
Chemical Substances	Antifibrinolytic Agents ; Hemoglobins ; Tranexamic Acid (6T84R30KC1)
Language	English
Publishing date	2021-02-06
Publishing country	Brazil
Document type	Journal Article ; Randomized Controlled Trial
ISSN	2352-2291
ISSN (online)	2352-2291
DOI	10.1016/j.bjane.2021.02.011
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Article: Pericardial Fluid Annexin A1 Is a Marker of Atrial Fibrillation in Aortic Stenosis: A Proteomics Analysis.

Fragão-Marques, Mariana / Vitorino, Rui / Barroso, Isaac / Falcão-Pires, Inês / Leite-Moreira, Adelino / Trindade, Fábio

Journal of personalized medicine

2022 Volume 12, Issue 2

Abstract: Atrial fibrillation (AF) is the most common arrhythmia with adverse clinical outcomes. Pericardial fluid (PF) mirrors the heart's pathophysiological status due to its proximity. This study aimed to characterise the PF proteome to identify new biomarkers ... ...

Abstract	Atrial fibrillation (AF) is the most common arrhythmia with adverse clinical outcomes. Pericardial fluid (PF) mirrors the heart's pathophysiological status due to its proximity. This study aimed to characterise the PF proteome to identify new biomarkers of disease. Eighty-three patients submitted to aortic valve replacement surgery with severe aortic stenosis were selected, and their baseline echocardiographic and clinical variables were documented. Thirteen samples were selected blindly for proteome characterisation following a shotgun (GeLC-MS/MS) and a label-free quantification approach (LFQ). According to previous AF history, a partial least squares discriminant analysis (PLS-DA) was conducted, and the top 15 variables important in projection were identified. To inquire potential biomarkers, ROC curves were designed using LFQ data. Target proteins were further validated by ELISA, in both pericardial fluid and serum. Proteome analysis uncovered nine proteins up- and downregulated ≥2-fold. Annexin A1, annexin A2, and vimentin were among the top 15 most important variables for group discrimination in PLS-DA. Protein-protein interaction and gene ontology enrichment analysis presented functional interaction among identified proteins, which were all part of focal adhesion sites. Annexin A1 was increased in the pericardial fluid of AF patients but not in serum when quantified by ELISA. Annexin A1 is a novel pericardial fluid biomarker of AF in patients with severe aortic stenosis.
Language	English
Publishing date	2022-02-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662248-8
ISSN	2075-4426
ISSN	2075-4426
DOI	10.3390/jpm12020264
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Article ; Online: Association of metabolic syndrome components and NAFLD with quality of life: Insights from a cross-sectional study.

Borges-Canha, Marta / Leite, Ana Rita / Godinho, Tiago / Liberal, Rodrigo / Correia-Chaves, Joana / Lourenço, Inês Mariana / von Hafe, Madalena / Vale, Catarina / Fragão-Marques, Mariana / Pimentel-Nunes, Pedro / Leite-Moreira, Adelino / Carvalho, Davide / Freitas, Paula / Neves, João Sérgio

Primary care diabetes

2024 Volume 18, Issue 2, Page(s) 196–201

Abstract: Aim: Metabolic syndrome (MetS) is associated with higher cardiovascular and metabolic risks, as well as with psychosocial disorders. Data regarding quality of life (QoL) in patients with MetS, point towards a significative association between MetS and a ...

Abstract	Aim: Metabolic syndrome (MetS) is associated with higher cardiovascular and metabolic risks, as well as with psychosocial disorders. Data regarding quality of life (QoL) in patients with MetS, point towards a significative association between MetS and a worse QoL. It remains unclear whether MetS components and non-alcoholic fatty liver disease (NAFLD) are associated with QoL in these individuals. We aimed to evaluate the association between QoL of patients with MetS and prespecified metabolic parameters (anthropometric, lipidic and glucose profiles), the risk of hepatic steatosis and fibrosis, and hepatic elastography parameters. Methods: Cross-sectional study including patients from microDHNA cohort. This cohort includes patients diagnosed with MetS, 18 to 75 years old, followed in our tertiary center. The evaluation included anamnesis, physical examination, a QoL questionnaire (Short-Form Health Survey, SF-36), blood sampling and hepatic elastography. We used ordered logistic regression models adjusted to sex, age and body mass index to evaluate the associations between the QoL domains evaluated by SF-36 and the prespecified parameters. Results: We included a total of 65 participants with MetS, with 54% being female and the mean age 61.9 ± 9.6 years old. A worse metabolic profile, specifically higher waist circumference, lower HDL, higher triglycerides, and more severe hepatic steatosis, were associated with worse QoL scores in several domains. We found no significant association of hepatic fibrosis with QoL. Conclusion: Our data suggests that there is a link between a worse metabolic profile (specifically poorer lipidic profile and presence of hepatic steatosis) and a worse QoL in patients with MetS.
MeSH term(s)	Humans ; Female ; Middle Aged ; Aged ; Adolescent ; Young Adult ; Adult ; Male ; Non-alcoholic Fatty Liver Disease/diagnostic imaging ; Non-alcoholic Fatty Liver Disease/complications ; Metabolic Syndrome/diagnosis ; Metabolic Syndrome/metabolism ; Cross-Sectional Studies ; Quality of Life ; Lipids
Chemical Substances	Lipids
Language	English
Publishing date	2024-01-23
Publishing country	England
Document type	Journal Article
ZDB-ID	2273997-X
ISSN	1878-0210 ; 1751-9918
ISSN (online)	1878-0210
ISSN	1751-9918
DOI	10.1016/j.pcd.2024.01.004
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Article ; Online: Adverse remodeling in atrial fibrillation following isolated aortic valve replacement surgery.

Oliveira, João Pedro / Fragão-Marques, Mariana / Lourenço, André / Falcão-Pires, Inês / Leite-Moreira, Adelino

Perfusion

2020 Volume 36, Issue 5, Page(s) 482–490

Abstract: Background: Atrial fibrillation (AF) is the most common arrhythmia with adverse clinical outcomes. Aortic valve replacement (AVR) is one of the most frequently performed cardiac surgeries, although there is scarce evidence on arrhythmic outcomes. We ... ...

Abstract	Background: Atrial fibrillation (AF) is the most common arrhythmia with adverse clinical outcomes. Aortic valve replacement (AVR) is one of the most frequently performed cardiac surgeries, although there is scarce evidence on arrhythmic outcomes. We aimed to evaluate AF during the first year post- isolated aortic valve replacement surgery and its clinical, analytical, and echocardiographic predictors. Methods: Severe aortic stenosis patients with no prior atrial fibrillation submitted to isolated aortic valve replacement surgery were included in our study, of which 316 remained in sinus rhythm and 24 developed AF. We performed logistic regression searching for AF predictors and a longitudinal comparison between pre and post-operative echocardiographic data. Results: Postoperative AF (POAF), diabetes, and follow-up indexed Left Atrium Diameter (iLAD) were significantly higher in the group of patients developing AF. POAF and iLAD were independent AF predictors at follow-up. No differences between groups were found regarding baseline and follow-up echocardiographic data except for indexed Left Ventricle End-diastolic Diameter (LVED), which failed to decrease after surgery in the AF group. Conclusions: POAF and iLAD independently predicted AF at 1 year following isolated AVR surgery in aortic stenosis patients with no AF history. iLVED did not decrease significantly at follow-up in AF patients, possibly reflecting adverse ventricular remodeling.
MeSH term(s)	Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Aortic Valve Stenosis/etiology ; Aortic Valve Stenosis/surgery ; Atrial Fibrillation/etiology ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation/adverse effects ; Humans ; Risk Factors
Language	English
Publishing date	2020-08-24
Publishing country	England
Document type	Journal Article
ZDB-ID	645038-6
ISSN	1477-111X ; 0267-6591
ISSN (online)	1477-111X
ISSN	0267-6591
DOI	10.1177/0267659120949210
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Article ; Online: Gender Differences in Predictors and Long-Term Mortality of New-Onset Postoperative Atrial Fibrillation Following Isolated Aortic Valve Replacement Surgery.

Fragão-Marques, Mariana / Mancio, Jennifer / Oliveira, João / Falcão-Pires, Inês / Leite-Moreira, Adelino

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia

2020 Volume 26, Issue 6, Page(s) 342–351

Abstract: Purpose: Postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG) has been associated with increased risk of death in women but not in men. We aimed to explore predictors and long-term mortality in POAF following isolated ... ...

Abstract	Purpose: Postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG) has been associated with increased risk of death in women but not in men. We aimed to explore predictors and long-term mortality in POAF following isolated aortic valve replacement (AVR) surgery in men and women. Methods: This study included 379 severe aortic stenosis patients with no prior atrial fibrillation (AF) who underwent isolated AVR surgery. We used multiple logistic regression to investigate independent gender-specific predictors of new-onset POAF, and we performed Kaplan-Meier (KM) to determine the impact of POAF in long-term mortality according to gender. Results: Advanced age and coronary artery disease prevalence were higher among POAF patients in both genders. On multiple analysis, increased postoperative peak lactate was independently associated with POAF in men, while lower mean aortic valve gradient was associated with POAF in women. Area under the curve (AUC) for the model was 0.77 [0.68-0.86] and 0.69 [0.60-0.78] for men and women, respectively. At 4-year follow-up, POAF was linked to increased risk of death in men but not in women. Conclusion: In severe aortic stenosis, factors associated with POAF and its impact on mortality differed between genders, with an increased risk of death observed only in men.
MeSH term(s)	Aged ; Aged, 80 and over ; Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Aortic Valve Stenosis/diagnostic imaging ; Aortic Valve Stenosis/mortality ; Aortic Valve Stenosis/surgery ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/etiology ; Atrial Fibrillation/mortality ; Female ; Heart Valve Prosthesis Implantation/adverse effects ; Heart Valve Prosthesis Implantation/mortality ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Severity of Illness Index ; Sex Factors ; Time Factors ; Treatment Outcome
Language	English
Publishing date	2020-04-28
Publishing country	Japan
Document type	Comparative Study ; Journal Article
ZDB-ID	2019756-1
ISSN	2186-1005 ; 1341-1098
ISSN (online)	2186-1005
ISSN	1341-1098
DOI	10.5761/atcs.oa.19-00314
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Article: Predictive Risk Score for Acute Kidney Injury in Hematopoietic Stem Cell Transplant.

Rodrigues, Natacha / Fragão-Marques, Mariana / Costa, Cláudia / Branco, Carolina / Marques, Filipe / Vasconcelos, Pedro / Martins, Carlos / Leite-Moreira, Adelino / Lopes, José António

Cancers

2023 Volume 15, Issue 14

Abstract: Hematopoietic stem cell transplant (HSCT) is an important treatment option for hematologic malignancies. Acute kidney injury (AKI) is a common complication in HSCTs and is related to worse outcomes. We aimed to create a predictive risk score for AKI in ... ...

Abstract	Hematopoietic stem cell transplant (HSCT) is an important treatment option for hematologic malignancies. Acute kidney injury (AKI) is a common complication in HSCTs and is related to worse outcomes. We aimed to create a predictive risk score for AKI in HSCT considering variables available at the time of the transplant. We performed a retrospective cohort study. AKI was defined by the KDIGO classification using creatinine and urinary output criteria. We used survival analysis with competing events. Continuous variables were dichotomized according to the Liu index. A multivariable analysis was performed with a backward stepwise regression. Harrel's C-Statistic was used to evaluate the performance of the model. Points were attributed considering the nearest integer of two times each covariate's hazard ratio. The Liu index was used to establish the optimal cut-off. We included 422 patients undergoing autologous (61.1%) or allogeneic (38.9%) HSCTs for multiple myeloma (33.9%), lymphoma (27.3%), and leukemia (38.8%). AKI cumulative incidence was 59.1%. Variables eligible for the final score were: hematopoietic cell transplant comorbidity index ≥2 (HR: 1.47, 95% CI: 1.08-2.006;
Language	English
Publishing date	2023-07-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15143720
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