Percorrer por autor "Fonseca, C"
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- A 2018 overview of diuretic resistance in heart failurePublication . Jardim, S; Ramos dos Santos, L; Araújo, I; Marques, F; Branco, P; Gaspar, A; Fonseca, CAbstract Heart failure is a disease with high direct and indirect costs. Current treatment includes drugs that alter disease progression and drugs that to improve symptoms. Loop diuretics are the cornerstone of congestion relief for acute management, as well as for chronic stabilization. In heart failure patients, maximal diuretic response is reduced by many individual factors. Diuretic resistance is defined as failure to achieve effective congestion relief despite appropriate or escalating diuretic doses. Its causes include impaired delivery of the diuretic to its luminal site of action, neurohormonal activation, tubular compensatory adaptation and drug interactions. Several strategies can be employed to aid decongestion of patients with impaired diuretic response. These include salt restriction, a higher effective single dose or higher dose frequency of loop diuretics, continuous infusion of diuretics and/or sequential nephron blockade through a synergistic combination of two or more diuretics from different classes. Ultrafiltration has also been found to be another effective and safe therapeutic option and should be considered in patients with refractory diuretic resistance. Overall, there is a lack of high-quality clinical data to guide the choice of treatment strategy and therapy should be tailored on a case-by-case basis.
- Mental health-promoting intervention models in university students: a systematic review and meta-analysis protocolPublication . Amaro, P; Fonseca, C; Pereira, A; Afonso, A; Barros, M L; Serra, I; Marques, M F; et al.Background The transition to higher education represents a demanding adaptation process with several socioeconomic factors involved. Mental health problems among university students have been worsening since the beginning of the COVID-19 pandemic. Our objective is to create scientific evidence about the models of mental health-promoting interventions among higher education students applied in academic environments, as well as their effectiveness. We aim to synthesise the scientific evidence on the models of an intervention promoting mental health among university students applied in academic environments as well as their results. Methods and analysis A systematic review of the literature will be conducted. The research will be carried out using the EBSCO databases (CINAHL Complete, MEDLINE Complete, Psychology and Behavioral Sciences Collection), PubMed and Scopus. The research strategy includes the following MeSH or similar terms: Universities [Mesh], Students [Mesh], Education [Mesh], Undergraduate, “Higher Education”, Universit*, College, Student*; “Psychosocial intervention” [Mesh], “Non-pharmacological”, “Intervention model*“, “Mental health promotion program*“, Intervention*; “Randomized Controlled Trial”, RCT; “Mental health” [Mesh], Depression [Mesh], Anxiety [Mesh], “Stress, psychological” [Mesh], “Quality of life” [Mesh], and “Psychological well-being” [Mesh]. All experimental studies with mental health-promoting interventions for university students that were published between January 2017 and November 2024 in English will be eligible. Two independent reviewers will apply the inclusion and exclusion criteria, analyse the quality of the data and extract it for synthesis. Disagreements will be resolved by a third reviewer. All randomised controlled trial studies with interventions in university students and their efficacy (with means and SD) will be included in the systematic review of the literature. The standardised mean difference will be used as the effect size to standardise individual results. Sensitivity analysis, subgroup analysis and meta-regression will be conducted to explore the causes of heterogeneity and the robustness of the results. Ethics and dissemination Ethical approval is not required for this study as it is based on the review of previously published data. The results will be disseminated through publication in peer-reviewed journals and presentations at academic conferences, as well as in events organised by student associations