Daniela Malta - Academia.edu (original) (raw)
Papers by Daniela Malta
Journal of Human Hypertension
The World Hypertension League Science of Salt health outcomes review series highlights high-quali... more The World Hypertension League Science of Salt health outcomes review series highlights high-quality publications relating to salt intake and health outcomes. This review uses a standardised method, outlined in previous reviews and based on methods developed by WHO, to identify and critically appraise published articles on dietary salt intake and health outcomes. We identified 41 articles published between September 2019 to December 2020. Amongst these, two studies met the pre-specified methodological quality criteria for critical appraisal. They were prospective cohort studies and examined physical performance and composite renal outcomes as health outcomes. Both found an association between increased/higher sodium intake and poorer health outcomes. Few studies meet criteria for high-quality methods. This review adds further evidence that dietary salt reduction has health benefits and strengthens evidence relating to health outcomes other than blood pressure and cardiovascular disea...
The American Journal of Clinical Nutrition, 2016
Background: Reduced potassium excretion caused by angiotensinconverting enzyme inhibitors (ACEis)... more Background: Reduced potassium excretion caused by angiotensinconverting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs) may increase the risk of hyperkalemia (serum potassium concentration .5 mmol/L) in the setting of increased potassium intake. Objective: The purpose of this study was to assess the effect of increasing dietary potassium on serum potassium concentration in hypertensive individuals with normal renal function treated with an ACEi or ARB. We hypothesized that an increase in dietary potassium would not provoke hyperkalemia in this population despite treatment with either an ACEi or ARB. Design: We conducted a controlled, parallel-design clinical trial in 20 hypertensive subjects with normal renal function treated with an ACEi or ARB, with random assignment to a usual diet or a high-potassium diet (HKD). Fruit and vegetable intake was used to increase potassium intake. Serum potassium concentration, 3-d food records, and 24-h urine collections were completed at baseline and 4 wk. Results: In the usual-diet group there were no statistically significant differences for potassium excretion, intake, or serum levels at end of study compared with baseline. The HKD group had significant differences in urinary potassium excretion (83 6 26 mmol/d at baseline compared with 109 6 35 mmol/d at 4 wk, P = 0.01) and dietary potassium intake (3775 6 1189 mg/d at baseline compared with 5212 6 1295 mg/d at 4 wk, P = 0.02). Despite increased potassium intake in the HKD group, serum potassium concentrations did not significantly increase from baseline at midpoint or end of study (4.1 6 0.6, 4.3 6 0.3, and 4.2 6 0.4 mmol/L, respectively). Conclusion: This study demonstrates that an increase in dietary potassium over a 4-wk period is safe in hypertensive subjects who have normal renal function and are receiving ACEi and/or ARB therapy. This trial was registered at www.clinicaltrials.gov as NCT02759367.
Muitas mulheres que desenvolvem cancro da mama (CM) são pós-menopáusicas, o que as predispõem par... more Muitas mulheres que desenvolvem cancro da mama (CM) são pós-menopáusicas, o que as predispõem para a osteoporose. Os tratamentos sistémicos do CM, incluindo a quimioterapia e a terapêutica endócrina, diminuem o nível de estrogénios circulantes tanto na mulher pré como na pós-menopausa, acelerando o processo natural de perda óssea. Esta perda óssea acelerada levará a um aumento das fracturas, dor crónica, e perda da mobilidade. Os bifosfonatos (BFs) têm vários papéis importantes no doente com cancro. São altamente efectivos em lentificar a taxa de perda óssea em mulheres pós-menopausicas com osteoporose e na prevenção de eventos relacionados com o esqueleto em mulheres com CM metastizado. Muitos estudos estão agora a focar-se no papel dos BFs na prevenção da perda óssea induzida pelo tratamento do cancro na situação adjuvante. Além do efeito no osso e nos osteoclastos, há emergentes evidências de efeitos directos e indirectos dos BFs na célula do cancro, e possivelmente sinergismo com os agentes anti-neoplásicos. Dados de vários estudos em curso esclarecerão o papel dos BFs na terapêutica adjuvante nos próximos anos. Os inibidores da aromatase (IAs) são uma terapêutica endócrina aceite na mulher pós-menopáusica com CM precoce e receptores hormonais positivos (RH+), com eficácia superior àquela do tamoxifeno (TAM). Verificou-se uma forte evidência em ensaios clínicos do papel dos BFs na prevenção da perda óssea associada aos IAs, com toxicidade aceitável. Noutros estudos, sobre a terapêutica adjuvante no CM precoce, os BFs foram associados a significativo melhoramento no prognóstico do cancro. Nesta revisão discutiremos o papel crescente dos BFs na situação adjuvante do CM, incluindo dados que indicam que os BFs não só promovem a saúde óssea, mas também podem prevenir a recorrência de doença e prolongar a sobrevida.
Revista Portuguesa de Clínica Geral, 2019
SUBACUTE THYROIDITIS, AN UNCOMMON CAUSE OF ODYNOPHAGIA: CASE REPORT Introduction: Subacute thyroi... more SUBACUTE THYROIDITIS, AN UNCOMMON CAUSE OF ODYNOPHAGIA: CASE REPORT Introduction: Subacute thyroiditis, or De Quervain's thyroiditis, is an uncommon condition. It can manifest itself as an anterior neck pain with radiation into the oropharynx, leading to odynophagia, a very common symptom in primary care. This case report demonstrates the importance of being aware of this clinical entity as a differential diagnosis of odynophagia, particularly when in presence of symptoms and signs of thyrotoxicosis. Case description: 36-years old female, presenting with fever, odynophagia sore throat and swollen neck, initially treated as an upper respiratory tract infection. Since no clinical improvement was observed, the patient was reassessed and clinical signs of thyroid pathology were identified. The diagnosis of subacute thyroiditis was based on biochemical markers of inflammation and thyrotoxicosis, as well as on the exclusion of autoimmune and bacterial causes. The treatment plan included symptomatic control with anti-inflammatory drugs, with improvement of symptoms over the following weeks. Subsequently, the patient developed an hypothyroidism and was treated with levothyroxine therapy. Comment: The early diagnosis of subacute thyroiditis may not be easy due its initial presentation, and may suggest a common pharyngitis. Although being an uncommon diagnosis, this diagnosis should be considered when in presence of odynophagia / neck pain and fever and other symptoms/signs should be searched, in order to minimise patient discomfort and healthcare resources' spending.
A suboptimal fetal environment increases the risk to develop cardiovascular disease in the adult.... more A suboptimal fetal environment increases the risk to develop cardiovascular disease in the adult. We reported previously that intrauterine stress in response to reduced uteroplacental blood flow in the pregnant rat limits fetal growth and compromises renal development, leading to an altered renal function in the adult offspring. Here we tested the hypothesis that high dietary sodium intake in rats with impaired renal development attributable to intrauterine stress, results in increased blood pressure, altered renal function, and organ damage. In rats, intrauterine stress was induced by bilateral ligation of the uterine arteries at day 17 of pregnancy. At the age of 12 weeks, the offspring was given high-sodium drinking water ( 2% sodium chloride). At the age of 16 weeks, rats were instrumented for monitoring of blood pressure and renal function. After intrauterine stress, litter size and birth weight were reduced, whereas hematocrit at birth was increased. Renal blood flow, glomerul...
Journal of Human Hypertension
The World Hypertension League Science of Salt health outcomes review series highlights high-quali... more The World Hypertension League Science of Salt health outcomes review series highlights high-quality publications relating to salt intake and health outcomes. This review uses a standardised method, outlined in previous reviews and based on methods developed by WHO, to identify and critically appraise published articles on dietary salt intake and health outcomes. We identified 41 articles published between September 2019 to December 2020. Amongst these, two studies met the pre-specified methodological quality criteria for critical appraisal. They were prospective cohort studies and examined physical performance and composite renal outcomes as health outcomes. Both found an association between increased/higher sodium intake and poorer health outcomes. Few studies meet criteria for high-quality methods. This review adds further evidence that dietary salt reduction has health benefits and strengthens evidence relating to health outcomes other than blood pressure and cardiovascular disea...
The American Journal of Clinical Nutrition, 2016
Background: Reduced potassium excretion caused by angiotensinconverting enzyme inhibitors (ACEis)... more Background: Reduced potassium excretion caused by angiotensinconverting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs) may increase the risk of hyperkalemia (serum potassium concentration .5 mmol/L) in the setting of increased potassium intake. Objective: The purpose of this study was to assess the effect of increasing dietary potassium on serum potassium concentration in hypertensive individuals with normal renal function treated with an ACEi or ARB. We hypothesized that an increase in dietary potassium would not provoke hyperkalemia in this population despite treatment with either an ACEi or ARB. Design: We conducted a controlled, parallel-design clinical trial in 20 hypertensive subjects with normal renal function treated with an ACEi or ARB, with random assignment to a usual diet or a high-potassium diet (HKD). Fruit and vegetable intake was used to increase potassium intake. Serum potassium concentration, 3-d food records, and 24-h urine collections were completed at baseline and 4 wk. Results: In the usual-diet group there were no statistically significant differences for potassium excretion, intake, or serum levels at end of study compared with baseline. The HKD group had significant differences in urinary potassium excretion (83 6 26 mmol/d at baseline compared with 109 6 35 mmol/d at 4 wk, P = 0.01) and dietary potassium intake (3775 6 1189 mg/d at baseline compared with 5212 6 1295 mg/d at 4 wk, P = 0.02). Despite increased potassium intake in the HKD group, serum potassium concentrations did not significantly increase from baseline at midpoint or end of study (4.1 6 0.6, 4.3 6 0.3, and 4.2 6 0.4 mmol/L, respectively). Conclusion: This study demonstrates that an increase in dietary potassium over a 4-wk period is safe in hypertensive subjects who have normal renal function and are receiving ACEi and/or ARB therapy. This trial was registered at www.clinicaltrials.gov as NCT02759367.
Muitas mulheres que desenvolvem cancro da mama (CM) são pós-menopáusicas, o que as predispõem par... more Muitas mulheres que desenvolvem cancro da mama (CM) são pós-menopáusicas, o que as predispõem para a osteoporose. Os tratamentos sistémicos do CM, incluindo a quimioterapia e a terapêutica endócrina, diminuem o nível de estrogénios circulantes tanto na mulher pré como na pós-menopausa, acelerando o processo natural de perda óssea. Esta perda óssea acelerada levará a um aumento das fracturas, dor crónica, e perda da mobilidade. Os bifosfonatos (BFs) têm vários papéis importantes no doente com cancro. São altamente efectivos em lentificar a taxa de perda óssea em mulheres pós-menopausicas com osteoporose e na prevenção de eventos relacionados com o esqueleto em mulheres com CM metastizado. Muitos estudos estão agora a focar-se no papel dos BFs na prevenção da perda óssea induzida pelo tratamento do cancro na situação adjuvante. Além do efeito no osso e nos osteoclastos, há emergentes evidências de efeitos directos e indirectos dos BFs na célula do cancro, e possivelmente sinergismo com os agentes anti-neoplásicos. Dados de vários estudos em curso esclarecerão o papel dos BFs na terapêutica adjuvante nos próximos anos. Os inibidores da aromatase (IAs) são uma terapêutica endócrina aceite na mulher pós-menopáusica com CM precoce e receptores hormonais positivos (RH+), com eficácia superior àquela do tamoxifeno (TAM). Verificou-se uma forte evidência em ensaios clínicos do papel dos BFs na prevenção da perda óssea associada aos IAs, com toxicidade aceitável. Noutros estudos, sobre a terapêutica adjuvante no CM precoce, os BFs foram associados a significativo melhoramento no prognóstico do cancro. Nesta revisão discutiremos o papel crescente dos BFs na situação adjuvante do CM, incluindo dados que indicam que os BFs não só promovem a saúde óssea, mas também podem prevenir a recorrência de doença e prolongar a sobrevida.
Revista Portuguesa de Clínica Geral, 2019
SUBACUTE THYROIDITIS, AN UNCOMMON CAUSE OF ODYNOPHAGIA: CASE REPORT Introduction: Subacute thyroi... more SUBACUTE THYROIDITIS, AN UNCOMMON CAUSE OF ODYNOPHAGIA: CASE REPORT Introduction: Subacute thyroiditis, or De Quervain's thyroiditis, is an uncommon condition. It can manifest itself as an anterior neck pain with radiation into the oropharynx, leading to odynophagia, a very common symptom in primary care. This case report demonstrates the importance of being aware of this clinical entity as a differential diagnosis of odynophagia, particularly when in presence of symptoms and signs of thyrotoxicosis. Case description: 36-years old female, presenting with fever, odynophagia sore throat and swollen neck, initially treated as an upper respiratory tract infection. Since no clinical improvement was observed, the patient was reassessed and clinical signs of thyroid pathology were identified. The diagnosis of subacute thyroiditis was based on biochemical markers of inflammation and thyrotoxicosis, as well as on the exclusion of autoimmune and bacterial causes. The treatment plan included symptomatic control with anti-inflammatory drugs, with improvement of symptoms over the following weeks. Subsequently, the patient developed an hypothyroidism and was treated with levothyroxine therapy. Comment: The early diagnosis of subacute thyroiditis may not be easy due its initial presentation, and may suggest a common pharyngitis. Although being an uncommon diagnosis, this diagnosis should be considered when in presence of odynophagia / neck pain and fever and other symptoms/signs should be searched, in order to minimise patient discomfort and healthcare resources' spending.
A suboptimal fetal environment increases the risk to develop cardiovascular disease in the adult.... more A suboptimal fetal environment increases the risk to develop cardiovascular disease in the adult. We reported previously that intrauterine stress in response to reduced uteroplacental blood flow in the pregnant rat limits fetal growth and compromises renal development, leading to an altered renal function in the adult offspring. Here we tested the hypothesis that high dietary sodium intake in rats with impaired renal development attributable to intrauterine stress, results in increased blood pressure, altered renal function, and organ damage. In rats, intrauterine stress was induced by bilateral ligation of the uterine arteries at day 17 of pregnancy. At the age of 12 weeks, the offspring was given high-sodium drinking water ( 2% sodium chloride). At the age of 16 weeks, rats were instrumented for monitoring of blood pressure and renal function. After intrauterine stress, litter size and birth weight were reduced, whereas hematocrit at birth was increased. Renal blood flow, glomerul...