Browsing by Author "Fernandes, Rúben"
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- Microvascular, biochemical, and clinical impact of hyperbaric oxygen therapy in recalcitrant diabetic foot ulcersPublication . Martins-Mendes, Daniela; Costa, Raquel; Rodrigues, Ilda; Camacho, Óscar; Coelho, Pedro Barata; Paixão-Dias, Vítor; Luís, Carla; Pereira, Ana Cláudia; Fernandes, Rúben; Lima, Jorge; Soares, RaquelBackground: Diabetic foot ulcers (DFUs) are a serious complication of diabetes and are often difficult to treat. Hyperbaric oxygen therapy (HBOT) has been proposed as an adjunctive treatment to promote healing, but its long-term clinical and biological effects remain insufficiently characterized. This study aimed to evaluate the impact of HBOT on systemic biomarkers, local microvasculature, and clinical outcomes in patients with DFUs. Methods: In this non-randomized prospective study, 20 patients with ischemic DFUs were followed over a 36-month period. Fourteen received HBOT in addition to standard care, while six received standard care alone. Clinical outcomes—including DFU resolution, recurrence, lower extremity amputation (LEA), and mortality—were assessed alongside systemic inflammatory and angiogenic biomarkers and wound characteristics at baseline and at 3, 6, 12, and 36 months. CD31 immunostaining was performed on available tissue samples. Results: The two groups were comparable at baseline (mean age 62 ± 12 years; diabetes duration 18 ± 9 years). At 3 months, the HBOT group showed significant reductions in erythrocyte sedimentation rate and DFU size (p < 0.05), with downward trends observed in C-reactive protein (CRP), vascular endothelial growth factor (VEGF), and placental growth factor (PlGF), and an increase in stromal-derived factor-1 alpha (SDF1-?). No significant changes were observed in the control group. CD31+ microvessel density appeared to increase in HBOT-treated DFU tissue after one month, although the sample size was limited. Patients receiving HBOT had lower rates of LEA and mortality, improved wound healing, and sustained outcomes over three years. DFU recurrence rates were similar between groups. Conclusions: HBOT was associated with improved wound healing and favorable biomarker profiles in patients with treatment-resistant ischemic DFUs. While these findings are encouraging, the small sample size and non-randomized design limit their generalizability, highlighting the need for larger, controlled studies.
- Pharmacogenomics, CYP2D6, and tamoxifen: a survey of the reasons sustaining European clinical practice paradigmsPublication . Reis, Sara S.; Carvalho, Ana S.; Fernandes, RúbenTamoxifen is a drug that is often used in the clinical management of breast cancer. CYP2D6 is a key metabolizing enzyme that is involved in the conversion of tamoxifen to its active drug metabolites. CYP2D6 has several alleles that metabolize tamoxifen and other drugs at different rates that can alter therapeutic impact, a characteristic that renders it one of the most studied enzymes in the field of pharmacogenetics. Background and objectives: Portugal has no implemented measures based on pharmacogenomics analysis prior to therapy that might function as a cultural sample control when analyzing the individual and economic factors present in clinical practice paradigms. Therefore, we aim to investigate the impact of CYP2D6 genotyping of the tamoxifen metabolizing enzymes in the clinical management of breast cancer patients. Materials and Methods: Qualitative/quantitative studies regarding the impact of pharmacogenomics in breast cancer; personal interviews in different Portuguese laboratories within hospital setting using a survey. Analysis of data through interviews to management board and/or decision makers from major oncological centers. Results: Reasons for common adoption of pharmacogenomics practice are contradictory and based both in economic factors and cultural/clinical bias. Conclusions: This research study identifies specific cultural and/or clinical bias that act as obstacles to pharmacogenomic implementation and proposes viable courses of action that might bring about change in cultural/medical habits.
- The magic cocktail: ampicillin and biosynthesized gold nanoparticles synergism against staphylococcus aureusPublication . Oliveira, Marco; Soares, Silvia; Sá, Sara; Gestoso, Álvaro; Correa-Duarte, Miguel; Baylina, Pilar; Fernandes, Rúben; Pereira, Carla F.Gold nanoparticles (AuNPs) have garnered attention as a potential alternative to conventional antibiotics due to their innovative antibacterial properties. This study demonstrates the successful production of biosynthetic gold nanoparticles (bAuNPs) using Pseudomonas aeruginosa (P. aeruginosa) as spherical nanostructures at 58 °C for 24 h, under alkaline pH (9.0). The successful synthesis of bAuNPs was confirmed through UV-Vis spectroscopy, exhibiting a characteristic peak within the 500–600 nm wavelength range, and the evaluation of the main functional groups and morphology were stressed by Fourier Transform Infrared Spectroscopy (FT-IR) and Transmission Electron Microscopy (TEM), respectively. Subsequently, the synthesized bAuNPs were combined with low concentrations of ampicillin and evaluated against Methicillin-Susceptible Staphylococcus aureus (MSSA) and Methicillin-Resistant Staphylococcus aureus (MRSA) through the classical serial dilution method. This innovative approach holds the potential to address the escalating issue of antibiotic resistance, providing a viable and sustainable solution.