Centro Clínico Académico / Clinical Academic Center (2CA-Braga)
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2CA–BRAGA - CENTRO CLÍNICO ACADÉMICO
O Centro Clínico Académico (CCA) é uma parceria, sem fins lucrativos, entre o Hospital de Braga e a Universidade do Minho, através da Escola de Ciências da Saúde e do Instituto de Ciências da Vida e da Saúde.
O CCA tem por objecto social o desenvolvimento da investigação clínica, enquadrada num ambiente de prestação de cuidados de saúde, e a promoção e produção de conhecimento no sentido de tornar os cuidados clínicos mais efectivos, melhorando a qualidade e eficiência assistencial.
O CCA encontra-se sediado no Hospital de Braga, possuindo para o desenvolvimento da sua actividade uma ala – semelhante a de um Serviço de Internamento – composta por diversos espaços adaptáveis ao desenvolvimento dos projectos de investigação em curso.
Objectivos Gerais
1. Implementação de estrutura independente que desenvolva investigação clínica e de translação de excelência;
2. Constituição de mecanismos de cooperação que tornem possível a participação conjunta em projectos, estudos e exploração de novas ideias e pesquisas de soluções inovadoras.
Objectivos específicos
1. Promover sinergias entre parceiros complementares;
2. Alavancar as competências individuais;
3. Desenvolver e fortalecer o potencial humano;
4. Implementar estudos de investigação de clínica e translação;
5. Implementar estudos epidemiológicos;
6. Identificar novas oportunidades de investigação;
7. Promover a aplicabilidade da investigação;
8. Desenvolver candidaturas em conjunto a programas de investigação.
Instrumentos de acção
1. Projectos de investigação;
2. Ensaios clínicos com medicamentos;
3. Investigação com dispositivos médicos.
Contactos
email: c.clinico.academico@ecsaude.uminho.pt | aline.vasconcelos@hospitaldebraga.pt
Morada: Hospital de Braga, Lugar de Sete Fontes, S. Victor 4710-243 Braga Portugal
Saiba mais em ccabraga.org
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- Stress Impact on Resting State Brain NetworksPublication . Soares, JM; Sampaio, A; Ferreira, LM; Santos, NC; Marques, PS; Marques, F; Palha, JA; Cerqueira, JJ; Sousa, NResting state brain networks (RSNs) are spatially distributed large-scale networks, evidenced by resting state functional magnetic resonance imaging (fMRI) studies. Importantly, RSNs are implicated in several relevant brain functions and present abnormal functional patterns in many neuropsychiatric disorders, for which stress exposure is an established risk factor. Yet, so far, little is known about the effect of stress in the architecture of RSNs, both in resting state conditions or during shift to task performance. Herein we assessed the architecture of the RSNs using functional magnetic resonance imaging (fMRI) in a cohort of participants exposed to prolonged stress (participants that had just finished their long period of preparation for the medical residence selection exam), and respective gender- and age-matched controls (medical students under normal academic activities). Analysis focused on the pattern of activity in resting state conditions and after deactivation. A volumetric estimation of the RSNs was also performed. Data shows that stressed participants displayed greater activation of the default mode (DMN), dorsal attention (DAN), ventral attention (VAN), sensorimotor (SMN), and primary visual (VN) networks than controls. Importantly, stressed participants also evidenced impairments in the deactivation of resting state-networks when compared to controls. These functional changes are paralleled by a constriction of the DMN that is in line with the pattern of brain atrophy observed after stress exposure. These results reveal that stress impacts on activation-deactivation pattern of RSNs, a finding that may underlie stress-induced changes in several dimensions of brain activity.
- Plasticity of resting state brain networks in recovery from stressPublication . Soares, JM; Sampaio, A; Marques, P; Ferreira, LM; Santos, NC; Marques, F; Palha, JA; Cerqueira, JJ; Sousa, NChronic stress has been widely reported to have deleterious impact in multiple biological systems. Specifically, structural and functional remodeling of several brain regions following prolonged stress exposure have been described; importantly, some of these changes are eventually reversible. Recently, we showed the impact of stress on resting state networks (RSNs), but nothing is known about the plasticity of RSNs after recovery from stress. Herein, we examined the "plasticity" of RSNs, both at functional and structural levels, by comparing the same individuals before and after recovery from the exposure to chronic stress; results were also contrasted with a control group. Here we show that the stressed individuals after recovery displayed a decreased resting functional connectivity in the default mode network (DMN), ventral attention network (VAN), and sensorimotor network (SMN) when compared to themselves immediately after stress; however, this functional plastic recovery was only partial as when compared with the control group, as there were still areas of increased connectivity in dorsal attention network (DAN), SMN and primary visual network (VN) in participants recovered from stress. Data also shows that participants after recovery from stress displayed increased deactivations in DMN, SMN, and auditory network (AN), to levels similar to those of controls, showing a normalization of the deactivation pattern in RSNs after recovery from stress. In contrast, structural changes (volumetry) of the brain areas involving these networks are absent after the recovery period. These results reveal plastic phenomena in specific RSNs and a functional remodeling of the activation-deactivation pattern following recovery from chronic-stress, which is not accompanied by significant structural plasticity.
- Brain structure across the lifespan: the influence of stress and moodPublication . Soares, JM; Marques, P; Magalhães, R; Santos, NC; Sousa, NNormal brain aging is an inevitable and heterogeneous process characterized by a selective pattern of structural changes. Such heterogeneity arises as a consequence of cumulative effects over the lifespan, including stress and mood effects, which drive different micro- and macro-structural alterations in the brain. Investigating these differences in healthy age-related changes is a major challenge for the comprehension of the cognitive status. Herein we addressed the impact of normal aging, stress, mood, and their interplay in the brain gray and white matter (WM) structure. We showed the critical impact of age in the WM volume and how stress and mood influence brain volumetry across the lifespan. Moreover, we found a more profound effect of the interaction of aging/stress/mood on structures located in the left hemisphere. These findings help to clarify some divergent results associated with the aging decline and to enlighten the association between abnormal volumetric alterations and several states that may lead to psychiatric disorders.
- Cerebral and cerebellar MRI volumes in Williams syndromePublication . Osório, A; Soares, JM; Prieto, MF; Vasconcelos, C; Fernandes, C; Sousa, SB; Carracedo, A; Gonçalves, OF; Sampaio, AIndividuals with Williams syndrome (WS) present a set of cognitive, affective and motor symptoms that resemble those of patients with lesions to the cerebellum. Although there is some evidence for overall structural alterations in this brain region in WS, explorations on cerebellar white matter and cerebellar cortex volumes remain rather neglected. We aimed to compare absolute and relative cerebellar volumes, as well as patterns of white matter to cortex volumes in this brain region, between a group of individuals with WS and a group of healthy controls. T1-weighted magnetic resonance images were acquired in 17 individuals with WS and in 15 typically developing individuals. Our results showed that even though individuals from the clinical group had significantly smaller cerebrums (and cerebellums), cerebellar volumes relative to intracranial volumes were significantly enlarged. In addition, while gray matter was relatively spared and white matter disproportionately reduced in the cerebrum in WS, relative cerebellar cortex and white matter volumes were preserved. These findings support the hypothesis that volume alterations in the cerebellum are associated with the cognitive, affective and motor profiles in WS.
- The role of sex and sex-related hormones in cognition, mood and well-being in older men and womenPublication . Castanho, TC; Moreira, PS; Portugal-Nunes, C; Novais, A; Costa, PS; Palha, JA; Sousa, N; Santos, NCAlterations in hormone levels during aging impact on cognition and mood. Serum concentration levels of testosterone (TT), estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), dehydroepiandrosterone sulfate (DHEAS) and prolactin (PRL) were assessed in 120 community-dwellers (51+ years of age, males and females), in a cross-sectional approach. Performance clusters based on executive functioning (GENEXEC), memory (MEM), mood and well-being were obtained. In males, higher PRL levels associated with worse cognitive performance, lower well-being, and higher scores in depression scales, and lower E2 with poorer cognition and higher depressive mood. DHEAS positively associated with GENEXEC and MEM. Nutritional status significantly associated with PRL (positively) and with DHEAS (negatively). Findings indicate that besides the more exhaustively studied E2 and TT, variations in the levels of sex-related hormones such as PRL, FSH, LH and DHEAS are of interest for the mental health aging profile particularly in men.
- Extensive Subcutaneous Emphysema as a Presentation of Ischemic ColitisPublication . Carvalho, AF; Branco, C; Leão, P; Antunes, CIntroduction. Subcutaneous emphysema is usually benign and self-limited; however, it may be associated with a life-threating situation. Case Report. An elderly woman with progressive malaise with extensive subcutaneous emphysema (cervical to abdominal wall) was observed at the emergency department. Colonic perforation was diagnosed and the patient underwent surgery. Intraoperatively, necrosis and perforation of the sigmoid colon into the retroperitoneum were found and a Hartmann procedure was performed. Conclusion. Cervical and thoracic subcutaneous emphysema may be the first sign of intra-abdominal lesion.
- Ki-67 Expression in CRC Lymph Node Metastasis Does Not Predict SurvivalPublication . Martins, SF; Amorim, R; Mota, SC; Costa, L; Pardal, F; Mesquita-Rodrigues, A; Longatto-Filho, AColorectal cancer is one of the most common malignancies and a leading cause of cancer death worldwide. Molecular markers may improve clinicopathologic staging and provide a basis to guide novel therapeutic strategies which target specific tumour-associated molecules according to individual tumour biology; however, so far, no ideal molecular marker has been found to predict disease progression. We tested Ki-67 proliferation marker in primary and lymph node metastasis of CRC. We observed a statistical significant difference between the positive rates of neoplastic cells positively stained by Ki-67 in both sites, with remarkable increased number of Ki-67 positive cells in primary tumor cells compared to cancer cells that invaded lymph nodes. We can speculate that the metastatic CRC in lymph node can be more resistant to the drugs that target cellular division.
- The Bounds Of Education In The Human Brain ConnectomePublication . Marques, P; Soares, JM; Magalhães, R; Santos, NC; Sousa, NInter-individual heterogeneity is evident in aging; education level is known to contribute for this heterogeneity. Using a cross-sectional study design and network inference applied to resting-state fMRI data, we show that aging was associated with decreased functional connectivity in a large cortical network. On the other hand, education level, as measured by years of formal education, produced an opposite effect on the long-term. These results demonstrate the increased brain efficiency in individuals with higher education level that may mitigate the impact of age on brain functional connectivity.
- Is "plausibility" a core feature of obsessions?Publication . Morgado, P
- Effector memory CD4(+) T cells are associated with cognitive performance in a senior populationPublication . Serre-Miranda, C; Roque, S; Santos, NC; Portugal-Nunes, C; Costa, P; Palha, JA; Sousa, N; Correia-Neves, MOBJECTIVE: Immunosenescence and cognitive decline are common markers of the aging process. Taking into consideration the heterogeneity observed in aging processes and the recently described link between lymphocytes and cognition, we herein explored the possibility of an association between alterations in lymphocytic populations and cognitive performance. METHODS: In a cohort of cognitively healthy adults (n = 114), previously characterized by diverse neurocognitive/psychological performance patterns, detailed peripheral blood immunophenotyping of both the innate and adaptive immune systems was performed by flow cytometry. RESULTS: Better cognitive performance was associated with lower numbers of effector memory CD4(+) T cells and higher numbers of naive CD8(+) T cells and B cells. Furthermore, effector memory CD4(+) T cells were found to be predictors of general and executive function and memory, even when factors known to influence cognitive performance in older individuals (e.g., age, sex, education, and mood) were taken into account. CONCLUSIONS: This is the first study in humans associating specific phenotypes of the immune system with distinct cognitive performance in healthy aging.