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Article ; Online: From Psoriasis to Psoriatic Arthritis: Ultrasound Insights Connecting Psoriasis with Subclinical Musculoskeletal Inflammation and the Path to Psoriatic Arthritis.

Ribeiro, A L / Eder, L

2024

Abstract: Purpose of review: This review summarizes the literature about the transition from psoriasis to psoriatic arthritis (PsA), focusing on musculoskeletal ultrasound (MSUS) for detecting subclinical inflammation and its role in diagnosis and triage of high- ... ...

Abstract	Purpose of review: This review summarizes the literature about the transition from psoriasis to psoriatic arthritis (PsA), focusing on musculoskeletal ultrasound (MSUS) for detecting subclinical inflammation and its role in diagnosis and triage of high-risk patients. Recent findings: MSUS effectively detects subclinical musculoskeletal inflammation in patients with psoriasis; however, some of these lesions are non-specific and can be found in healthy individuals. Preliminary evidence suggest that subclinical sonographic findings may predict progression to PsA in psoriasis patients. MSUS can also improve referrals' accuracy and its integration in the PsA classification criteria may improve early PsA detection. MSUS is a valuable tool for detecting subclinical abnormalities in psoriasis patients, which indicate an increased likelihood of progressing to PsA. Its integration into referral protocols and clinical use could improve PsA diagnosis. We propose an MSUS-inclusive algorithm for PsA referrals and triage, which requires validation. The potential of early intervention in reducing PsA progression in psoriasis patients with subclinical inflammation remains to be established.
Language	English
Publishing date	2024-03-21
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057357-1
ISSN	1534-6307 ; 1523-3774
ISSN (online)	1534-6307
ISSN	1523-3774
DOI	10.1007/s11926-024-01146-9
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Zs.A 5531: Show issues

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Article ; Online: Pharmacologic Treatment Strategies in Psoriatic Arthritis.

Ayan, G / Ribeiro, A / Macit, Betul / Proft, Fabian

Clinical therapeutics

2023 Volume 45, Issue 9, Page(s) 826–840

Abstract: Purpose: The goal of this narrative review was to provide current data on psoriatic arthritis (PsA) therapeutic strategies, supporting treatment decisions with a domain-based approach.: Methods: This narrative review of treatment strategies for PsA ... ...

Abstract	Purpose: The goal of this narrative review was to provide current data on psoriatic arthritis (PsA) therapeutic strategies, supporting treatment decisions with a domain-based approach. Methods: This narrative review of treatment strategies for PsA focused on several disease domains (ie, peripheral arthritis, enthesitis, axial disease, dactylitis, skin and nail disease), as well as the so-called "related conditions" of uveitis, Crohn's disease, and ulcerative colitis. We searched PubMed, EMBASE, international guidelines, and recent congress abstracts. Findings: Currently, multiple approved treatment options offer a wide range of options, such as tumor necrosis factor (TNF) inhibitors; inhibitors of interleukin-17 (IL-17), IL-12/23 (IL-12/23), IL-23 (IL-23), and Janus kinase; the phosphodiesterase 4 inhibitor apremilast; and the T-cell modulator abatacept. However, no treatment option shows clear superiority concerning efficacy on peripheral arthritis and dactylitis over the others, whereas limited evidence suggests that the IL-17 inhibitor ixekizumab and the IL-12/23 inhibitor ustekinumab may be superior to TNF inhibitors in treating enthesitis. Recent data on enthesitis have also shown promising results for methotrexate. Treatment of axial PsA is mostly derived from axial spondyloarthritis, and more data are needed focusing on this specific subgroup of PsA patients. Thus far, the most important finding from the only randomized controlled trial in this specific population is that the IL-17 inhibitor secukinumab was superior to placebo in terms of clinical and radiologic end-points in axial PsA. Regarding psoriatic skin involvement, head-to-head trials in PsA as well as skin psoriasis showed the superiority of IL-17, IL-23, and IL-12/23 inhibitors over TNF inhibitors. When treating PsA with concurrent uveitis, according to the existing data, monoclonal TNF inhibitor antibodies should be preferred. In PsA and concomitant inflammatory bowel disease, treatment decisions must include the consideration of which specific type of inflammatory bowel disease (Crohn's disease or ulcerative colitis) is present, as some of the agents either lack data or are ineffective in treating these 2 conditions. In both types, IL-17 inhibitors should be avoided. When determining treatment strategy, comorbidities should be carefully assessed, and the corresponding risk profile of the respective treatment modalities should be taken into consideration. Implications: There are many approved therapeutic options for treating patients with PsA, and additional emerging treatment options are in the pipeline. Individualized treatment decisions for each patient, depending on the leading disease phenotype, underlying comorbidities, and patient preferences, should be made based on shared decision-making.
Language	English
Publishing date	2023-07-15
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	603113-4
ISSN	1879-114X ; 0149-2918
ISSN (online)	1879-114X
ISSN	0149-2918
DOI	10.1016/j.clinthera.2023.05.010
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Zs.A 1435: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Role of nanotechnology in the prolonged release of drugs by the subcutaneous route.

Rama, B / Ribeiro, A J

Expert opinion on drug delivery

2023 Volume 20, Issue 5, Page(s) 559–577

Abstract: Introduction: Subcutaneous physiology is distinct from other parenteral routes that benefit the administration of prolonged-release formulations. A prolonged-release effect is particularly convenient for treating chronic diseases because it is ... ...

Abstract	Introduction: Subcutaneous physiology is distinct from other parenteral routes that benefit the administration of prolonged-release formulations. A prolonged-release effect is particularly convenient for treating chronic diseases because it is associated with complex and often prolonged posologies. Therefore, drug-delivery systems focused on nanotechnology are proposed as alternatives that can overcome the limitations of current therapeutic regimens and improve therapeutic efficacy. Areas covered: This review presents an updated systematization of nanosystems, focusing on their applications in highly prevalent chronic diseases. Subcutaneous-delivered nanosystem-based therapies comprehensively summarize nanosystems, drugs, and diseases and their advantages, limitations, and strategies to increase their translation into clinical applications. An outline of the potential contribution of quality-by-design (QbD) and artificial intelligence (AI) to the pharmaceutical development of nanosystems is presented. Expert opinion: Although recent academic research and development (R&D) advances in the subcutaneous delivery of nanosystems have exhibited promising results, pharmaceutical industries and regulatory agencies need to catch up. The lack of standardized methodologies for analyzing in vitro data from nanosystems for subcutaneous administration and subsequent in vivo correlation limits their access to clinical trials. There is an urgent need for regulatory agencies to develop methods that faithfully mimic subcutaneous administration and specific guidelines for evaluating nanosystems.
MeSH term(s)	Pharmaceutical Preparations ; Artificial Intelligence ; Nanotechnology ; Drug Delivery Systems ; Injections, Subcutaneous
Chemical Substances	Pharmaceutical Preparations
Language	English
Publishing date	2023-06-12
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2167286-6
ISSN	1744-7593 ; 1742-5247
ISSN (online)	1744-7593
ISSN	1742-5247
DOI	10.1080/17425247.2023.2214362
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Book ; Online: Sampling and Uniqueness Sets in Graphon Signal Processing

Parada-Mayorga, Alejandro / Ribeiro, Alejandro

2024

Abstract: In this work, we study the properties of sampling sets on families of large graphs by leveraging the theory of graphons and graph limits. To this end, we extend to graphon signals the notion of removable and uniqueness sets, which was developed ... ...

Abstract	In this work, we study the properties of sampling sets on families of large graphs by leveraging the theory of graphons and graph limits. To this end, we extend to graphon signals the notion of removable and uniqueness sets, which was developed originally for the analysis of signals on graphs. We state the formal definition of a $\Lambda-$removable set and conditions under which a bandlimited graphon signal can be represented in a unique way when its samples are obtained from the complement of a given $\Lambda-$removable set in the graphon. By leveraging such results we show that graphon representations of graphs and graph signals can be used as a common framework to compare sampling sets between graphs with different numbers of nodes and edges, and different node labelings. Additionally, given a sequence of graphs that converges to a graphon, we show that the sequences of sampling sets whose graphon representation is identical in $[0,1]$ are convergent as well. We exploit the convergence results to provide an algorithm that obtains approximately close to optimal sampling sets. Performing a set of numerical experiments, we evaluate the quality of these sampling sets. Our results open the door for the efficient computation of optimal sampling sets in graphs of large size.
Keywords	Computer Science - Machine Learning ; Electrical Engineering and Systems Science - Signal Processing
Subject code	511
Publishing date	2024-01-11
Publishing country	us
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Correction to: Animal Models to Study Cancer and Its Microenvironment.

Mendes, N / Dias Carvalho, P / Martins, F / Mendonça, S / Malheiro, A R / Ribeiro, A / Carvalho, J / Velho, S

Advances in experimental medicine and biology

2024 Volume 1219, Page(s) C1

Language	English
Publishing date	2024-02-16
Publishing country	United States
Document type	Published Erratum
ZDB-ID	410187-X
ISSN	0065-2598
ISSN	0065-2598
DOI	10.1007/978-3-030-34025-4_24
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Zs.A 3192: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Einzelsignatur: Show issues

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Article: Acute Encephalopathy in a 10-Year-Old Patient With Maple Syrup Urine Disease: A Challenging Diagnosis.

Miragaia, Pedro / Grangeia, Ana / Rodrigues, Esmeralda / Sousa, Raquel / Ribeiro, Augusto

Cureus

2024 Volume 16, Issue 1, Page(s) e53043

Abstract: Maple syrup urine disease (MSUD) is a rare autosomal recessive metabolic disorder characterized by a deficiency in the branched-chain alpha-keto acid dehydrogenase complex, leading to the toxic accumulation of leucine, isoleucine and valine. Acute ... ...

Abstract	Maple syrup urine disease (MSUD) is a rare autosomal recessive metabolic disorder characterized by a deficiency in the branched-chain alpha-keto acid dehydrogenase complex, leading to the toxic accumulation of leucine, isoleucine and valine. Acute encephalopathy (AE) is a severe neurological disorder with diverse etiologies, demanding prompt identification and intervention. We present a unique case of a previously healthy teenage patient who developed AE during an influenza infection. Despite initial inconclusive investigations, the patient's condition rapidly deteriorated, requiring pediatric intensive care unit (PICU) admission. Diagnostic challenges included fluctuating mental status and refractory intracranial hypertension, ultimately necessitating decompressive craniectomy. Empirical treatments, including corticosteroids, tocilizumab, and plasmapheresis, were administered. Finally, clinical exome analysis revealed a pathogenic variant in homozygosity in the BCKDHA gene associated with MSUD type Ia. Her adult sister, experiencing similar symptoms in the same time period, did not survive. This case underscores the importance of considering metabolic disorders in AE etiology, even accounting for its various associated syndromes and usual prolonged diagnostic investigation, as prompt treatment initiation is vital for improved outcomes. Management of AE involves addressing seizures, systemic support and neuromonitoring, namely, intracranial pressure monitoring. Inborn errors of metabolism, like MSUD, should be considered, even if universally screened, as delayed diagnosis can result in prolonged hospitalization and significant morbidity.
Language	English
Publishing date	2024-01-27
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.53043
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Article: White matter hyperintensities in bipolar disorder: systematic review and meta-analysis.

Silva, Tânia / Nunes, Cesar / Ribeiro, Andreia / Santana, Isabel / Cerejeira, Joaquim

Frontiers in psychiatry

2024 Volume 15, Page(s) 1343463

Abstract: Background: White matter hyperintensities are lesions of presumed vascular origin associated with Cerebral small vessel disease. WMH are common findings that and are associated with increased risk of cognitive impairment and dementia. A higher ... ...

Abstract	Background: White matter hyperintensities are lesions of presumed vascular origin associated with Cerebral small vessel disease. WMH are common findings that and are associated with increased risk of cognitive impairment and dementia. A higher prevalence of WMH has been also reported in patients with bipolar disorder (BD), although the evidence is conflicting. Objective: To compare the prevalence of WMH in adults with BD, with the prevalence found in healthy controls. Methods: We searched the Embase, Medline/PubMed, and references cited in articles retrieved on May 20, 2023. We included case-control studies that compared the prevalence of WMH in adult BD patients with the prevalence of WMH in healthy controls, using T2-weighted magnetic resonance imaging. We performed a meta-analysis using a random-effects method based on the inverse-variance approach. Findings: We included 22 case-control studies reporting data of 1313 people. The overall rate of WMH was 46.5% in BD patients and 28% in controls (pooled Odds Ratio 2.89, 95% CI 1.76; 4.75). We found a moderate heterogeneity across studies (I Interpretation: We found evidence that BD patients have a higher burden of WMH than healthy controls. Main limitations were impossibility of analyzing gender differences and bipolar type, moderate heterogeneity between studies, non-representative samples, lack of control for major confounders and search in two electronic databases. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023428464.
Language	English
Publishing date	2024-01-26
Publishing country	Switzerland
Document type	Systematic Review
ZDB-ID	2564218-2
ISSN	1664-0640
ISSN	1664-0640
DOI	10.3389/fpsyt.2024.1343463
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Article ; Online: Statistical simplex centroid experimental design for evaluation of pectin, modified chitosan and modified starch as encapsulating agents on the development of vitamin E-loaded microparticles by spray-drying.

Ribeiro, A Marisa / Gonçalves, Antónia / Rocha, Fernando / Estevinho, Berta N

International journal of biological macromolecules

2024 , Page(s) 131792

Abstract: Vitamin E encapsulation into biopolymer-based microparticles, obtained by spray-drying technology, was proposed to improve the encapsulation efficiency and the controlled release of fat-soluble vitamin. Binary and ternary blends of pectin, modified ... ...

Abstract	Vitamin E encapsulation into biopolymer-based microparticles, obtained by spray-drying technology, was proposed to improve the encapsulation efficiency and the controlled release of fat-soluble vitamin. Binary and ternary blends of pectin, modified chitosan and modified starch, modified starch + modified chitosan, modified starch + pectin, modified chitosan + pectin and modified starch + modified chitosan + pectin ((0.33, 0.33, 0.33), (0.70, 0.15, 0.15), (0.15, 0.70, 0.15) and (0.15, 0.15, 0.70)) were proposed to produce and evaluate different carrier-based delivery systems. Vitamin E-loaded microparticles and empty microparticles were created with a product yield between 9 and 49 %. The mean diameter among all microparticles varied between 3.74 ± 0.02 and 421 ± 21 μm (differential volume distribution). Oval, spherical or irregular microparticles, with a variable morphology from a smooth to a high rough surface structure, with concavities, were produced. All vitamin E-loaded microparticles exhibited an encapsulation efficiency higher than 70 %. The slower vitamin E controlled release was observed from microparticles composed by modified chitosan (>36 h), while the faster release was achieved from microparticles individually composed by pectin (39 min). In general, the Fickian diffusion is the main release mechanism involved in the microparticles produced with modified chitosan, other formulations combine also other mechanisms such as swelling.
Language	English
Publishing date	2024-04-25
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	282732-3
ISSN	1879-0003 ; 0141-8130
ISSN (online)	1879-0003
ISSN	0141-8130
DOI	10.1016/j.ijbiomac.2024.131792
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Article ; Online: Is it advantageous to use quality by design (QbD) to develop nanoparticle-based dosage forms for parenteral drug administration?

Camacho Vieira, C / Peltonen, L / Karttunen, A P / Ribeiro, A J

International journal of pharmaceutics

2024 , Page(s) 124163

Abstract: Parenteral administration is one of the most commonly used drug delivery routes for nanoparticle-based dosage forms, such as lipid-based and polymeric nanoparticles. For the treatment of various diseases, parenteral administration include intravenous, ... ...

Abstract	Parenteral administration is one of the most commonly used drug delivery routes for nanoparticle-based dosage forms, such as lipid-based and polymeric nanoparticles. For the treatment of various diseases, parenteral administration include intravenous, subcutaneous, and intramuscular route. In drug development phase, multiparameter strategy with a focus on drug physicochemical properties and the specificity of the administration route is required. Nanoparticle properties in terms of size and targeted delivery, among others, are able to surpass many drawbacks of conventional dosage forms, but these unique properties can be a bottleneck for approval by regulatory authorities. Quality by Design (QbD) approach has been widely utilized in development of parenteral nanoparticle-based dosage forms. It fosters knowledge of product and process quality by involving sound scientific data and risk assessment strategies. A full and comprehensive investigation into the state of implementation and applications of the QbD approach in these complex drug products can highlight the gaps and challenges. In this review, the analysis of critical attributes and Design of Experiment (DoE) approach in different nanoparticulate systems, together with the proper utilization of Process Analytical Technology (PAT) applications are described. The essential of QbD approach for the design and development of nanoparticle-based dosage forms for delivery via parenteral routes is discussed thoroughly.
Language	English
Publishing date	2024-04-24
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	428962-6
ISSN	1873-3476 ; 0378-5173
ISSN (online)	1873-3476
ISSN	0378-5173
DOI	10.1016/j.ijpharm.2024.124163
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Zs.A 1409: Show issues

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Article: Primary Lateral Sclerosis: Can Rocuronium Be an Option?

Palha Ribeiro, Antonio / Tomas, Ana Sofia / Oliveira, Carla

Cureus

2023 Volume 15, Issue 3, Page(s) e35773

Abstract: Primary lateral sclerosis (PLS) is a neurodegenerative motor neuron disorder that is characterized by corticospinal and corticobulbar dysfunction. In this disease, muscle relaxants in general anesthesia should be used with extreme caution. A 67-year-old ... ...

Abstract	Primary lateral sclerosis (PLS) is a neurodegenerative motor neuron disorder that is characterized by corticospinal and corticobulbar dysfunction. In this disease, muscle relaxants in general anesthesia should be used with extreme caution. A 67-year-old woman with a history of PLS was scheduled for laparoscopic gastrostomy due to long-term dysphagia. In the preoperative assessment, she presented a tetrapyramidal syndrome with generalized muscle weakness. A priming dose of 5 mg of rocuronium was administered and the train-of-four (TOF) ratio (T4/T1) after 60 seconds was 70% so induction was followed with fentanyl, propofol, and additional 40 mg of rocuronium. After 90 seconds when T1 was lost, the patient was intubated. During surgery, the TOF ratio increased progressively until 65%, 22 minutes after a final bolus of 10 mg of rocuronium. Prior to emergence, 150 mg of sugammadex was given and neuromuscular block reversal was evidenced with a TOF ratio > 90%. As it was decided to perform the surgery laparoscopically, general anesthesia with a neuromuscular blockade was necessary. Since it is reported that patients with motor neuron diseases show an increased sensibility to non-depolarizing muscle relaxants (NDMR), these agents should be used cautiously. Adversely to what studies document, no augmented responsiveness was shown in TOF monitoring, so the standard dose of 0.6 mg/kg of rocuronium was safely given. A final bolus of NDMR was administered after 54 minutes, demonstrating a similar pharmacokinetics profile in terms of duration of action as reported in several studies (45-70 minutes). In addition, a full and rapid neuromuscular blockade recovery with 2 mg/kg of sugammadex was seen, as previously demonstrated in a case series.
Language	English
Publishing date	2023-03-05
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.35773
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