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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- Acute Alithiasic Cholecystitis and Human Herpes Virus Type-6 Infection: First CasePublication . Gomes, MM; Antunes, H; Lobo, AL; Branca, F; Correia-Pinto, J; Moreira-Pinto, JA three-year-old male child presented with erythematous maculopapular nonpruritic generalized rash, poor feeding, vomiting, and cramping generalized abdominal pain. He was previously healthy and there was no family history of immunologic or other diseases. On examination he was afebrile, hemodynamically stable, with painful palpation of the right upper quadrant and positive Murphy's sign. Laboratory tests revealed elevated inflammatory markers, elevated aminotransferase activity, and features of cholestasis. Abdominal ultrasound showed gallbladder wall thickening of 8 mm with a positive sonographic Murphy's sign, without gallstones or pericholecystic fluid. Acute Alithiasic Cholecystitis (AAC) was diagnosed. Tests for underlying infectious causes were negative except positive blood specimen for Human Herpes Virus Type-6 (HHV-6) by polymerase chain reaction. With supportive therapy the child became progressively less symptomatic with gradual improvement. The child was discharged on the sixth day, asymptomatic and with improved analytic values. Two months later he had IgM negative and IgG positive antibodies (1/160) for HHV-6, which confirmed the diagnosis of previous infection. In a six-month follow-up period he remains asymptomatic. To the best of our knowledge, this represents the first case of AAC associated with HHV-6 infection.
- Age effects on EEG correlates of the Wisconsin Card Sorting TestPublication . Dias, NS; Ferreira, D; Reis, J; Jacinto, LR; Fernandes, L; Pinho, F; Festa, J; Pereira, M; Afonso, N; Santos, NC; Cerqueira, JJ; Sousa, NBody and brain undergo several changes with aging. One of the domains in which these changes are more remarkable relates with cognitive performance. In the present work, electroencephalogram (EEG) markers (power spectral density and spectral coherence) of age-related cognitive decline were sought whilst the subjects performed the Wisconsin Card Sorting Test (WCST). Considering the expected age-related cognitive deficits, WCST was applied to young, mid-age and elderly participants, and the theta and alpha frequency bands were analyzed. From the results herein presented, higher theta and alpha power were found to be associated with a good performance in the WCST of younger subjects. Additionally, higher theta and alpha coherence were also associated with good performance and were shown to decline with age and a decrease in alpha peak frequency seems to be associated with aging. Additionally, inter-hemispheric long-range coherences and parietal theta power were identified as age-independent EEG correlates of cognitive performance. In summary, these data reveals age-dependent as well as age-independent EEG correlates of cognitive performance that contribute to the understanding of brain aging and related cognitive deficits.
- An uncommon diagnosis done by colonoscopyPublication . Costa, RS; Costa, JM; Ferreira, A; Gonçalves, R; Rolanda, C
- Assessing Cognitive Function in Older Adults Using a Videoconference ApproachPublication . Castanho, TC; Amorim, L; Moreira, PS; Mariz, J; Palha, JA; Sousa, N; Santos, NCBACKGROUND: The use of communication technologies is an emerging trend in healthcare and research. Despite efficient, reliable and accurate neuropsychological batteries to evaluate cognitive performance in-person, more diverse and less expensive and time consuming solutions are needed. Here we conducted a pilot study to determine the applicability of a videoconference (VC, Skype®) approach to assess cognitive function in older adults, using The Telephone Interview for Cognitive Status-Modified - Portuguese version (TICSM-PT). METHODS: After inclusion and exclusion criteria, 69 individuals (mean age=74.90±9.46years), selected from registries of local health centers and assisted-living facilities, were assessed on cognitive performance using videoconference, telephone and in-person approaches. FINDINGS: The videoconference administration method yielded comparable results to the traditional application. Correlation analyses showed high associations between the testing modalities: TICSM-PT VC and TICSM-PT telephone (r=0.885), TICSM-PT VC and MMSE face-to-face (r=0.801). Using the previously validated threshold for cognitive impairment on the TICSM-PT telephone, TICSM-PT VC administration presented a sensitivity of 87.8% and a specificity of 84.6%. INTERPRETATION: Findings indicate for the range of settings where videoconference approaches can be used, and for their applicability and acceptability, providing an alternative to current cognitive assessment methods. Continued validation studies and adaptation of neuropsychological instruments is warranted.
- Brain functional connectivity is altered in patients with Takotsubo SyndromePublication . Silva, AR; Magalhães, R; Arantes, C; Moreira, PS; Rodrigues, M; Marques, P; Marques, J; Sousa, N; Pereira, VHTakotsubo syndrome (TTS) is an acute, reversible cardiomyopathy. The central autonomic nervous system (ANS) is believed to play a role in this disease. The aim of the present study was to investigate the patterns of brain functional connectivity in a sample of patients who had experienced a previous episode of TTS. Brain functional connectivity, both at rest and in response to the stressful stimulus of topical cold stimulation, was explored using functional magnetic resonance imaging (fMRI), network-based statistics (NBS) and graph theory analysis (GTA) in a population consisting of eight patients with a previous episode of TTS and eight sex- and age-matched controls. At rest, a network characterized by increased connectivity in the TTS group compared to controls and comprising elements of the central ANS was identified. GTA revealed increased local efficiency, clustering and strength in regions of the bilateral hippocampus in subjects with a previous episode of TTS. When stressed by local exposure to cold, the TTS group differed significantly from both a pre-stress baseline interval and from the control group, showing increased connectivity in a network that included the left amygdala and the right insula. Based on the results, patients with TTS display a reorganization of cortical and subcortical networks, including areas associated with the emotional response and autonomic regulation. The findings tend to support the hypothesis that a deregulation of autonomic control at the central level plays a significant role in this syndrome.
- 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.
- Characterization of a large cluster of HIV-1 A1 infections detected in Portugal and connected to several Western European countriesPublication . Araújo, PM; Carvalho, A; Pingarilho, M; Abecasis, AB; Osório, NSHIV-1 subtypes associate with differences in transmission and disease progression. Thus, the existence of geographic hotspots of subtype diversity deepens the complexity of HIV-1/AIDS control. The already high subtype diversity in Portugal seems to be increasing due to infections with sub-subtype A1 virus. We performed phylogenetic analysis of 65 A1 sequences newly obtained from 14 Portuguese hospitals and 425 closely related database sequences. 80% of the A1 Portuguese isolates gathered in a main phylogenetic clade (MA1). Six transmission clusters were identified in MA1, encompassing isolates from Portugal, Spain, France, and United Kingdom. The most common transmission route identified was men who have sex with men. The origin of the MA1 was linked to Greece, with the first introduction to Portugal dating back to 1996 (95% HPD: 1993.6-1999.2). Individuals infected with MA1 virus revealed lower viral loads and higher CD4+ T-cell counts in comparison with those infected by subtype B. The expanding A1 clusters in Portugal are connected to other European countries and share a recent common ancestor with the Greek A1 outbreak. The recent expansion of this HIV-1 subtype might be related to a slower disease progression leading to a population level delay in its diagnostic.
- Correção Laparoscópica de Atresia Duodenal Associada a Pâncreas AnularPublication . Barroso, C; Correia-Pinto, JDuodenal atresia is the most common cause of congenital bowel obstruction. Often it is associated with other congenital anomalies, such as annular pancreas. The laparoscopic approach, although technically demanding, brings about clear benefits to the newborn. The authors report the case of a newborn with prenatal diagnosis of duodenal atresia, proposed for a laparoscopy, during which an annular pancreas was identified and a laparoscopic diamond-shaped duodenal anastomosis was performed.
- 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.