Percorrer por autor "Capela, Carlos"
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- Intervenções do EESMP na pessoa com diagnóstico de enfermagem “ansiedade”: desenvolvimento de competências especializadasPublication . Capela, Carlos; Casaleiro, TiagoO presente relatório constitui uma reflexão crítica sobre o percurso realizado no âmbito do Mestrado em Enfermagem de Saúde Mental e Psiquiátrica, evidenciando o desenvolvimento de competências comuns e específicas do EESMP. A vivência com doença mental, especialmente nos casos de ansiedade, pode comprometer significativamente a funcionalidade e a autonomia dos indivíduos, afetando as suas atividades de vida diária. Contudo, o papel do enfermeiro de saúde mental deve centrar-se nas respostas humanas ao sofrimento, reconhecendo a pessoa como um ser integral e singular em constante interação com o meio. As intervenções de enfermagem realizadas ao longo do estágio foram sustentadas por uma revisão da literatura, evidenciando a eficácia das intervenções especializadas em saúde mental. A Teoria das Transições de Afaf Meleis serviu como referencial teórico, orientando a prática e a abordagem ao cuidado. O processo formativo permitiu demonstrar um crescimento progressivo na aquisição, desenvolvimento e reconhecimento das competências do enfermeiro especialista em enfermagem de saúde mental. Estas competências foram consolidadas em três campos de estágio distintos: na comunidade, no internamento de doentes crónicos e no internamento de doentes agudos. As intervenções de enfermagem são direcionadas para a pessoa com ansiedade, abrangendo diferentes níveis de prevenção, reforçando a importância do papel do EE na promoção e prevenção da saúde mental e na qualidade dos cuidados prestados.
- Metabolic dysfunction and peroxisome proliferator-activated receptors (PPAR) in Multiple SclerosisPublication . Ferret-Sena, Véronique; Capela, Carlos; Sena, Armando"Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease of the central nervous system (CNS) probably caused, in most cases, by the interaction of genetic and environmental factors. This review first summarizes some clinical, epidemiological and pathological characteristics of MS. Then, the involvement of biochemical pathways is discussed in the development and repair of the CNS lesions and the immune dysfunction in the disease. Finally, the potential roles of peroxisome proliferator-activated receptors (PPAR) in MS are discussed. It is suggested that metabolic mechanisms modulated by PPAR provide a window to integrate the systemic and neurological events underlying the pathogenesis of the disease. In conclusion, the reviewed data highlight molecular avenues of understanding MS that may open new targets for improved therapies and preventive strategies for the disease."
- Oral contraceptives interact with adiposity-associated markers in patients with multiple sclerosisPublication . Ferret-Sena, Véronique; Ramos, Catarina; Cascais, Maria João; Capela, Carlos; Sena, ArmandoGrowing evidence suggests the involvement of adipose tissue in modulating the clinical course of relapsing–remitting multiple sclerosis (RRMS). This study aimed to investigate whether the intake of combined oral contraceptives (COCs) affects body weight and leptin and adiponectin (APN) blood levels in these patients. Clinical data from 62 women (M = 33.23 year) were recorded prior to the initiation of disease-modifying therapy. Patients who were taking COCs at the time of experiencing the first symptoms of disease (COC user) were compared with those who never used these formulations or stopped taking them before disease onset (COC non-user). Bivariate Pearson’s correlations and hierarchical multiple linear regressions analysis were conducted. Normalized APN levels were lower in the COC-using patients (p = 0.013). Negative correlations between waist circumference and normalized APN (p = 0.001) were observed only in the COC non-user patients. A longer duration of COC intake was associated with increased body mass index and waist circumference (p = 0.003). Normalized APN predicted the MS Severity Score (MSSS) (p = 0.020), but this correlation was lost in the COC user patients. After adjusting for confounders, only age (p = 0.027) and, later, disease onset (p = 0.014) were correlated with the MSSS. Larger and prospective studies are needed to investigate the interactions of sex steroids with adipose metabolism in modulating disease progression.
- Serum lipoprotein profile is associated with protective effects of oral contraceptive use on Multiple Sclerosis severity: a cross-sectional studyPublication . Sena, Armando; Macedo, Ana; Ferret-Sena, Véronique; Capela, Carlos; Pedrosa, Rui"Background: The mechanisms underlying the influence of sex hormones in multiple sclerosis (MS) are uncertain. Sex steroids interact with cholesterol metabolism and the serum lipid profile has been associated with the severity of the disease. We hypothesized that the putative associations between lipoprotein metabolism and MS could be modulated by sex steroids exposure. The aim of this study was to investigate whether oral contraceptives (OC) use changes the lipoprotein profile associated with disability in patients with multiple sclerosis. Methods: Clinical data was collected from 133 relapsing-remitting multiple sclerosis (RRMS) women with a mean of 6.5 years of disease duration and prior to the start of disease-modifying therapies. Patients who were using OC after disease onset (DO) (OC+, n = 57) were compared to those who never used OC or discontinued its intake before DO (OC-, n = 76). In both cohorts of subjects, the associations between the apolipoprotein E (ApoE) polymorphism, and plasma lipid levels, and the annualized relapse rate (RR), the Expanded Disability Status Score (EDSS), and the Multiple Sclerosis Severity Score (MSSS) were evaluated using a hierarchic multiple regression analysis after adjustment for confounders. Results: Low density lipoprotein (LDL) levels were associated with higher EDSS (p = 0.010) and MSSS (p = 0.024) in the whole studied cohort. In E3/E3 phenotype carriers (73.7%), EDSS and MSSS were lower in OC+ in comparison with OC- subgroup of patients (p < 0.01). LDL and total cholesterol were associated with EDSS (p = 0.005 and p = 0.043, respectively), and LDL and the triglyceride/high density lipoprotein ratio with MSSS (p = 0.011 and p = 0.048, respectively) in OC+ patients. In OC- subgroup of patients, ApoE levels were associated with EDSS (p = 0.012) and MSSS (p = 0.031). No significant interactions between the lipid variables or OC use and RR were observed. Conclusions: Serum lipid profile is associated with protective effects of OC use on disability of RRMS patients. Lipoprotein metabolism may be involved in the modulatory effects of sex steroids on the severity of the disease."