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Article ; Online: Thermal stress and comfort assessment in urban areas using Copernicus Climate Change Service Era 5 reanalysis and collected microclimatic data.

Silva, Tiago / Lopes, António / Vasconcelos, João / Chokhachian, Ata / Wagenfeld, Malte / Santucci, Daniele

2024 Volume 68, Issue 5, Page(s) 949–963

Abstract: In this initial study of a research project, this paper seeks to understand the thermal conditions in the cities of Lisbon and Munich, specifically focusing on Urban Heat Island intensity and on thermal comfort using the Universal Thermal Climate Index ... ...

Abstract	In this initial study of a research project, this paper seeks to understand the thermal conditions in the cities of Lisbon and Munich, specifically focusing on Urban Heat Island intensity and on thermal comfort using the Universal Thermal Climate Index modeling data at the Local Climate Zone scale. Based on these datasets, Munich has exhibited more unfavourable thermal conditions than Lisbon. In terms of UHII, both cities have shown that low, medium, and high rise compact urban areas and bare rock or paved areas have the highest values, while sparsely built areas have the lowest. These results differ from the UTCI, which indicates that in Lisbon and Munich, these sparsely built areas as well as areas with low plants and vegetation are the most uncomfortable. In Munich, the population was exposed to very strong heat stress, while Lisbon experienced strong heat stress conditions. Conversely, low, medium, and high rise compact urban areas and densely wooded areas in Munich, and scattered trees areas and large low-rise urban areas in Lisbon, have demonstrated the lowest monthly mean and average maximum values. These results will be further explored in future studies in the city of Lisbon and cross-checked with data obtained from roving missions. This will enable a more detailed temporal and local analysis.
MeSH term(s)	Cities ; Humans ; Climate Change ; Microclimate ; Germany ; Portugal ; Models, Theoretical ; Thermosensing ; Hot Temperature
Language	English
Publishing date	2024-02-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	280324-0
ISSN	1432-1254 ; 0020-7128
ISSN (online)	1432-1254
ISSN	0020-7128
DOI	10.1007/s00484-024-02639-z
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Article: Buerger's Disease - A Clinical Case.

Fernandes, Urânia / Vasconcelos, João / Marques, Rita / Pinto-de-Sousa, João / Almeida Pinto, João

Portuguese journal of cardiac thoracic and vascular surgery

2023 Volume 30, Issue 2, Page(s) 59–61

Abstract: Buerger's disease is a distal segmental nonatherosclerotic vasculopathy that involves the inferior and superior limbs of smoker males younger than 45 years old. This article aims to describe a clinical case and revise the literature about Buerger's ... ...

Abstract	Buerger's disease is a distal segmental nonatherosclerotic vasculopathy that involves the inferior and superior limbs of smoker males younger than 45 years old. This article aims to describe a clinical case and revise the literature about Buerger's disease. A 45-year-old smoker male repeatedly visited the emergency department for refractory pain and inflammatory signs in the right hallux. After developing ulcers in the right foot, Doppler ultrasonography revealed segmental occlusion of distal arteries of that limb. It was also observed in arteriography "corkscrew" collaterals. Autoimmune, thrombophilic and cardiovascular diseases were excluded. Analgesia, antibiotics and alprostadil were implemented. As a result, the patient stopped smoking and was submitted to minor amputation with complete healing, after which he remained asymptomatic. Buerger's disease is a diagnosis of exclusion. Therefore, smoking cessation is the most effective treatment and is crucial to prevent disease progression.
MeSH term(s)	Humans ; Male ; Middle Aged ; Thromboangiitis Obliterans/diagnosis ; Arteries ; Alprostadil/therapeutic use ; Pain/drug therapy ; Smoking/adverse effects
Chemical Substances	Alprostadil (F5TD010360)
Language	English
Publishing date	2023-07-07
Publishing country	Portugal
Document type	Journal Article
ISSN	2184-9927
ISSN	2184-9927
DOI	10.48729/pjctvs.259
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Article: Wound, Ischemia, Foot Infection (Wifi) Classification System And Its Predictive Ability Concerning Amputation-Free Survival, Mortality And Major Limb Amputation In A Portuguese Population: A Single Center Experience.

Alves, Duarte Gil / Ferreira, Vítor / Teixeira, Gabriela / Vasconcelos, João / Maia, Miguel / Vidoedo, José / Almeida Pinto, João

Portuguese journal of cardiac thoracic and vascular surgery

2024 Volume 30, Issue 4, Page(s) 51–58

Abstract: Introduction: Commonly used chronic limb-threatening ischemia (CLTI) classifications lack granularity and detail to precisely stratify patients according to risk of limb loss, expected revascularization benefit and mortality. The aim of this study is to ...

Abstract	Introduction: Commonly used chronic limb-threatening ischemia (CLTI) classifications lack granularity and detail to precisely stratify patients according to risk of limb loss, expected revascularization benefit and mortality. The aim of this study is to evaluate in a Portuguese population the prognostic value of an updated CLTI classification based on Wound, Ischemia, and foot Infection (WIfI) proposed by the Society for Vascular Surgery. Materials and methods: Single-center retrospective evaluation of prospectively collected data of consecutive patients with CLTI submitted to lower limb revascularization from January to December of 2017. All consecutive patients with chronic peripheral artery disease with ischemic rest pain or tissue loss were included. The exclusion criteria were patients with intermittent claudication, vascular trauma, acute ischemia, non-atherosclerotic arterial disease and isolated iliac intervention. The primary end-point was major limb amputation, mortality and amputation-free survival (AFS) at 30 days, 1 year and 2 year follow-up. Secondary end-points were minor amputation, wound healing time (WHT) and rate (WHR). Results: A total of 111 patients with CLTI were submitted to infra-inguinal revascularization: 91 endovascular and 20 open surgery. After categorizing them according to the WIfI: 20 had stage 1 (18.52%), 29 stage 2 (26.85%), 38 stage 3 (35.19%) and 21 stage 4 (19.44%). Overall mortality rate was 1.8%, 17% and 22.3% at 30 days, 1 year and 2 years follow-up. Major amputation rate was 0.9%, 2.7% and 2.7% at 30 days, 1 year and 2 years follow-up. AFS rate was 97.3%, 82.1%, and 76.8% at 30 days, 1 year, 2 years follow-up. In multi-variable analysis, higher WIfI score was the only predictive factor for mortality and AFS. WIfI 3 and 4 were also associated with increased risk of non-healing ulcer. Conclusion: This study proved the prognostic value of the WIfI classification in a Portuguese population by showing an association between higher scores and increased mortality, lower AFS and non-healing ulcer.
MeSH term(s)	Humans ; Treatment Outcome ; Risk Factors ; Limb Salvage/adverse effects ; Retrospective Studies ; Portugal/epidemiology ; Ulcer/etiology ; Wound Infection/diagnosis ; Amputation, Surgical ; Peripheral Arterial Disease/diagnosis ; Focal Infection/etiology ; Ischemia/diagnosis ; Chronic Limb-Threatening Ischemia
Language	English
Publishing date	2024-02-09
Publishing country	Portugal
Document type	Journal Article
ISSN	2184-9927
ISSN	2184-9927
DOI	10.48729/pjctvs.364
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Article: PERCUTANEOUS MECHANICAL THROMBECTOMY IN PHLEGMASIA CERULEA DOLENS: CASE REPORT AND LITERATURE REVIEW.

Vinha, André / Pimenta, Joana / Vasconcelos, João / Maia, Miguel / Vidoedo, José / Almeida Pinto, João

Portuguese journal of cardiac thoracic and vascular surgery

2022 Volume 28, Issue 4, Page(s) 59–62

Abstract: Introduction: Phlegmasia cerulea dolens is a potentially life-threatening complication of deep venous thrombosis, causing marked swelling and sudden severe pain in the limb, associated with cyanosis, edema and compartment syndrome that together ... ...

Abstract	Introduction: Phlegmasia cerulea dolens is a potentially life-threatening complication of deep venous thrombosis, causing marked swelling and sudden severe pain in the limb, associated with cyanosis, edema and compartment syndrome that together compromise arterial supply. There is no consensus on its treatment. Case report: A 36-year-old woman, with a history of cosmetic surgery 8 days before admission (abdominal liposuction), was admitted to the emergency department with edema, cyanosis, severe pain, decreased temperature and tenderness of the left lower limb. At physical exam, no distal pulses on the left lower limb were found. Angio-CT was performed, showing occlusion of left femoral vein, external and common iliac veins. The patient started treatment with enoxaparin (80 mg, subcutaneous, bid) and percutaneous mechanical thrombectomy (PMT) of the left iliac vein sector was performed, followed by balloon angioplasty and stenting of the left iliac vein sector. It was also deployed a temporary filter in the inferior vena cava. Thrombophilic workup was negative. The patient presented thorough clinical remission after the procedure (Villalta score 0). Two years after surgery, the patient is asymptomatic, and the Doppler ultrasound is unremarkable concerning morphologic changes throughout the left iliac vein sector. Conclusion: The treatment of phlegmasia cerulea dolens is challenging due to its severity and poor prognosis. Minimally invasive procedures, such as PMT can be an alternative to open surgery. It can also avoid the use of thrombolytics in patients with relative / absolute contraindications to its use.
MeSH term(s)	Adult ; Female ; Femoral Vein/diagnostic imaging ; Humans ; Iliac Vein/diagnostic imaging ; Thrombectomy ; Ultrasonography ; Venous Thrombosis/complications
Language	English
Publishing date	2022-01-04
Publishing country	Portugal
Document type	Case Reports ; Journal Article ; Review
ISSN	2184-9927
ISSN	2184-9927
DOI	10.48729/pjctvs.227
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Article ; Online: Clinical impact of unsuccessful subcutaneous administration of octreotide LAR instead of intramuscular administration in patients with metastatic gastroenteropancreatic neuroendocrine tumors.

Krishnan, Tharani / Safro, Maria / Furlanetto, Daniel Moreira / Gill, Sharlene / Solar Vasconcelos, Joao Paulo / Stuart, Heather C / Martineau, Patrick / Loree, Jonathan M

Journal of neuroendocrinology

2023 Volume 36, Issue 1, Page(s) e13360

Abstract: Octreotide LAR is a long-acting somatostatin analogue (SSA) used in the management of metastatic gastroenteropancreatic neuroendocrine tumors (GEP NETs). It requires intramuscular (IM) injection. Missed IM injections cause subcutaneous nodules (SCNs) on ... ...

Abstract	Octreotide LAR is a long-acting somatostatin analogue (SSA) used in the management of metastatic gastroenteropancreatic neuroendocrine tumors (GEP NETs). It requires intramuscular (IM) injection. Missed IM injections cause subcutaneous nodules (SCNs) on radiologic images. We reviewed the rates of SCNs in a real-world cohort of GEP NETs receiving octreotide LAR and explored treatment outcomes. Patients commencing octreotide LAR between August 5, 2010 and March 8, 2018 at a single cancer center in Canada were identified from pharmacy records. Patients were included if they had a computed tomography (CT) scan performed at the time of progression and a preceding CT with pelvis included to enable assessment for the presence of nodules. Fisher's exact test was used to examine predictors of SCNs, and Kaplan-Meier curves summarized differences in progression free (PFS) and overall survival (OS) that were compared with log-rank tests. Of 243 patients receiving octreotide LAR, 45 had all required CT images available for central review. SCNs were found in 20/45 (44%) of patients on the last scan showing stable disease before progression and were numerically but not statistically more likely in females (OR: 2.36, 95% CI: 0.66-8.29, p = .23). There was an increased risk of SCNs in patients with a skin-to-muscle distance >38 mm (the length of an octreotide LAR needle) on CT (OR: 5.09, 95% CI: 1.39-16.6, p = .018) and a trend toward increased risk in obese patients (OR: 5.71, 95% CI: 1.26-23.4, p = .061). PFS (HR: 1.01, 95% CI: 0.56-1.78, p = .98) and OS (HR: 0.86, 95% CI: 0.41-1.8, p = .70) was similar between those with/without SCNs. In conclusion, almost half of patients receiving octreotide LAR had SCNs; however, missed administration of SSA did not appear to result in worse survival in this small study. Factors such as sex, younger age skin-to-muscle distance, and obesity may affect SCN development and should be considered when choosing an SSA.
MeSH term(s)	Female ; Humans ; Neuroendocrine Tumors/drug therapy ; Octreotide/therapeutic use ; Pancreatic Neoplasms/drug therapy ; Somatostatin ; Stomach Neoplasms/drug therapy ; Male
Chemical Substances	Octreotide (RWM8CCW8GP) ; Somatostatin (51110-01-1)
Language	English
Publishing date	2023-12-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	1007517-3
ISSN	1365-2826 ; 0953-8194
ISSN (online)	1365-2826
ISSN	0953-8194
DOI	10.1111/jne.13360
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Article: Excess winter mortality and morbidity before, during, and after the Great Recession: the Portuguese case

Almendra, Ricardo / Perelman, Julian / Vasconcelos, Joao / Santana, Paula

International journal of biometeorology. 2019 July, v. 63, no. 7

2019

Abstract: Although winter mortality and morbidity are phenomena common to most European countries, their magnitude varies significantly from country to country. The geographical disparities among regions with similar climates are the result of several social, ... ...

Abstract	Although winter mortality and morbidity are phenomena common to most European countries, their magnitude varies significantly from country to country. The geographical disparities among regions with similar climates are the result of several social, economic, demographic, and biological conditions that influence an individual’s vulnerability to winter conditions. The impact of poor socioeconomic conditions may be of such magnitude that an economic recession may aggravate the seasonal mortality pattern. This paper aims to measure the seasonal winter mortality, morbidity, and their related costs during the Great Recession (2009–2012) in mainland Portugal and its Regional Health Administrations (RHAs) and to compare it with the periods preceding and following it. Monthly mortality and morbidity data were collected and clustered into three periods: Great Recession (2009–2012), Pre-Recession (2005–2008), and Post-Recession (2013–2016). The impact of seasonal winter mortality and morbidity during the Great Recession in Portugal and its Regional Health Administrations was measured through the assessment of age-standardized excess winter (EW) death and hospital admissions rate and index, expected life expectancy gains without EW deaths, EW rate of potential years of life lost, and EW rate of emergency hospital admission costs. Important increases of winter deaths and hospital admissions were identified, resulting in an important number of potential years of life lost (87 years of life lost per 100,000 inhabitants in 2009–2012), life expectancy loss (1 year in 2009–2012), and National Health Service costs with explicit temporal and spatial variations. These human and economic costs have decreased consistently during the analyzed periods, while no significant increase was found during the Great Recession. Despite its reduction, the winter excess morbidity and mortality highlight that Portugal still faces substantial challenges related to a highly vulnerable population, calling for investments in better social and health protection.
Keywords	at-risk population ; bioclimatology ; climate ; death ; disability-adjusted life year ; economic costs ; economic recession ; health services ; hospitals ; humans ; longevity ; morbidity ; mortality ; winter ; Portugal
Language	English
Dates of publication	2019-07
Size	p. 873-883.
Publishing place	Springer Berlin Heidelberg
Document type	Article
ZDB-ID	127361-9
ISSN	0067-8902 ; 0020-7128
ISSN	0067-8902 ; 0020-7128
DOI	10.1007/s00484-019-01700-6
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Excess winter mortality and morbidity before, during, and after the Great Recession: the Portuguese case.

Almendra, Ricardo / Perelman, Julian / Vasconcelos, Joao / Santana, Paula

International journal of biometeorology

2019 Volume 63, Issue 7, Page(s) 873–883

Abstract	Although winter mortality and morbidity are phenomena common to most European countries, their magnitude varies significantly from country to country. The geographical disparities among regions with similar climates are the result of several social, economic, demographic, and biological conditions that influence an individual's vulnerability to winter conditions. The impact of poor socioeconomic conditions may be of such magnitude that an economic recession may aggravate the seasonal mortality pattern. This paper aims to measure the seasonal winter mortality, morbidity, and their related costs during the Great Recession (2009-2012) in mainland Portugal and its Regional Health Administrations (RHAs) and to compare it with the periods preceding and following it. Monthly mortality and morbidity data were collected and clustered into three periods: Great Recession (2009-2012), Pre-Recession (2005-2008), and Post-Recession (2013-2016). The impact of seasonal winter mortality and morbidity during the Great Recession in Portugal and its Regional Health Administrations was measured through the assessment of age-standardized excess winter (EW) death and hospital admissions rate and index, expected life expectancy gains without EW deaths, EW rate of potential years of life lost, and EW rate of emergency hospital admission costs. Important increases of winter deaths and hospital admissions were identified, resulting in an important number of potential years of life lost (87 years of life lost per 100,000 inhabitants in 2009-2012), life expectancy loss (1 year in 2009-2012), and National Health Service costs with explicit temporal and spatial variations. These human and economic costs have decreased consistently during the analyzed periods, while no significant increase was found during the Great Recession. Despite its reduction, the winter excess morbidity and mortality highlight that Portugal still faces substantial challenges related to a highly vulnerable population, calling for investments in better social and health protection.
MeSH term(s)	Climate ; Europe ; Humans ; Morbidity ; Mortality ; Portugal ; Seasons
Language	English
Publishing date	2019-03-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	280324-0
ISSN	1432-1254 ; 0020-7128
ISSN (online)	1432-1254
ISSN	0020-7128
DOI	10.1007/s00484-019-01700-6
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Article ; Online: Multifractal fluctuations in zebrafish (Danio rerio) polarization time series.

Romaguera, Antonio R de C / Vasconcelos, João V A / Negreiros-Neto, Luis G / Pessoa, Nathan L / Silva, Jadson F da / Cadena, Pabyton G / Souza, Adauto J F de / Oliveira, Viviane M de / Barbosa, Anderson L R

The European physical journal. E, Soft matter

2024 Volume 47, Issue 5, Page(s) 29

Abstract: In this work, we study the polarization time series obtained from experimental observation of a group of zebrafish (Danio rerio) confined in a circular tank. The complex dynamics of the individual trajectory evolution lead to the appearance of multiple ... ...

Abstract	In this work, we study the polarization time series obtained from experimental observation of a group of zebrafish (Danio rerio) confined in a circular tank. The complex dynamics of the individual trajectory evolution lead to the appearance of multiple characteristic scales. Employing the Multifractal Detrended Fluctuation Analysis (MF-DFA), we found distinct behaviors according to the parameters used. The polarization time series are multifractal at low fish densities and their average scales with
MeSH term(s)	Zebrafish/physiology ; Animals ; Fractals
Language	English
Publishing date	2024-05-05
Publishing country	France
Document type	Journal Article
ZDB-ID	2004003-9
ISSN	1292-895X ; 1292-8941
ISSN (online)	1292-895X
ISSN	1292-8941
DOI	10.1140/epje/s10189-024-00423-w
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Article: SUPERFICIAL FEMORAL ARTERY OPPORTUNISTIC STUMP.

Maia, Miguel / Vidoedo, José / Vasconcelos, João / Ferreira, Vitor / Almeida Pinto, João

Portuguese journal of cardiac thoracic and vascular surgery

2021 Volume 28, Issue 2, Page(s) 15–17

Abstract: ...

Abstract	.
MeSH term(s)	Femoral Artery/diagnostic imaging ; Thigh/blood supply
Language	English
Publishing date	2021-07-02
Publishing country	Portugal
Document type	Journal Article
ISSN	2184-9927
ISSN	2184-9927
DOI	10.48729/pjctvs.163
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Article: ENDOVASCULAR PROCEDURES FOR LOWER LIMB PERIPHERAL ARTERIAL DISEASE IN AN AMBULATORY UNIT.

Carvas, João / Vidoedo, José / Maia, Miguel / Vasconcelos, João / Almeida Pinto, João

Portuguese journal of cardiac thoracic and vascular surgery

2021 Volume 28, Issue 2, Page(s) 33–38

Abstract: Objectives: To analyse the safety and outcomes of endovascular procedures in an ambulatory practice.: Methods: Data were collected from a cohort of patients admitted in an ambulatory unit for an endovascular procedure for lower limb (LL) arterial ... ...

Abstract	Objectives: To analyse the safety and outcomes of endovascular procedures in an ambulatory practice. Methods: Data were collected from a cohort of patients admitted in an ambulatory unit for an endovascular procedure for lower limb (LL) arterial occlusive disease during a one year period. Results: A total of 168 procedures were carried out in 134 patients. Patients' mean age was 67 (39-91) years and 78% were male. Most patients presented with lower limb ulcer or gangrene (43%) or disabling claudication (40%). Most frequent comorbidities included hypertension (75.4%), dyslipidemia (72.4%) and diabetes mellitus (57.5%). The preferred vascular access for the procedures was the common femoral artery (52%), superficial femoral artery (24%) and humeral artery (21%). Global complication rate was 19% but only one major, non-fatal complication was identified. The most common complication was arterial dissection (8.3%), none compromising blood flow. One-year amputation rate was 6.7%, and one-year mortality was 3.0%. Factors significantly associated with procedure complications were female sex, hypertension and dyslipidemia. Conclusion: Ambulatory endovascular procedures for PAD are safe and effective in selected patients. Both the low rate and low severity of complications make them an attractive option in the prospect of diminishing the burden of these patients on the health-care system while improving patient comfort.
MeSH term(s)	Aged ; Amputation ; Endovascular Procedures/adverse effects ; Female ; Humans ; Lower Extremity/surgery ; Male ; Peripheral Arterial Disease/surgery ; Treatment Outcome
Language	English
Publishing date	2021-07-02
Publishing country	Portugal
Document type	Journal Article
ISSN	2184-9927
ISSN	2184-9927
DOI	10.48729/pjctvs.167
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