Percorrer por autor "Guerreiro, Rui"
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- Barriers and strategies for pain management in non-verbal people with dementia in residential care facilities : protocol for an e-Delphi studyPublication . Félix, Isa Brito; Ramos, Catarina; Guerreiro, Rui; Hughes, Jeffery David; Hoti, Kreshnik; Andrade, Teresa; Guerreiro, Mara PereiraIntroduction: Pain is a prevalent symptom in people living with dementia. Evidence shows that pain frequently remains unrecognised and untreated in this vulnerable population, leading to avoidable suffering. Effective pain management is hindered by multifactorial barriers at the individual, organisational and policy level. This study aims to achieve expert consensus on the key barriers to pain management in non-verbal people living with dementia and strategies to address these barriers within Portuguese residential care facilities. Methods and analysis: An e-Delphi study will be conducted using two rounds of online questionnaires. The Behaviour Change Wheel (BCW) framework guided the development of e-Delphi statements by linking identified determinants (i.e., barriers and facilitators) to intervention functions. Barriers were extracted from the literature reviews and mapped into the capability, opportunity and motivation–behaviour model. Intervention functions were then selected using the BCW linkage matrices and operationalised into practical strategies. A purposive and snowball sampling approach will be used to recruit a heterogeneous panel of experts across national residential care facilities, including nurses, physicians, managers and policymakers with relevant experience in dementia. During the e-Delphi rounds, participants will be invited to rate the relevance of each barrier and associated strategy(ies) on a five-point Likert scale and provide comments or suggestions. Consensus will be defined as ≥75% agreement on each statement. Ethics and dissemination: Ethical approval for this study was obtained from the Egas Moniz Ethics Committee (Ref. 1586), and all procedures will comply with the Declaration of Helsinki. Informed consent will be obtained from all participants. The findings will be disseminated through a peer-reviewed publication, scientific events and stakeholder networks, including residential care facilities, to inform future practice and policy in dementia care.
- Knee Septic Arthritis after Palm Tree Thorn Injury: A Case ReportPublication . Ramos, Jorge Teixeira; Barbosa, Nuno; Almeida, João; Karmali, Samir; Guerreiro, Rui; Magalhães, GlóriaIntroduction:A monoarthritic painful knee may have multiple etiologies, of which septic arthritis is commonly considered to be one of the most deleterious pathologies. This type of acute symptom is, in the literature, for some rare cases, related to an inflammatory process secondary to a penetrating plant thorn, which was considered an aseptic process and therefore treated by removing the foreign body. This work reports a recent case falling into that diagnosis, which due to its infrequent nature, could have been misevaluated and consequently mistreated. Case Report: Our goal is to bring to the attention of the orthopedic community that this type of deleterious pathology, which is today uncommon, must never be fully disregarded. We share a case of a 68-year-old male who was admitted 2 days after being injured by a palm tree (Arecaceae) thorn with acute inflammatory signs and effusion in the left knee. Although, ultrasound excluded pathway or intra-articular foreign bodies, in the arthroscopic procedure, a thorn was found and removed. Pantoea agglomerans was identified in the synovial fluid. Conclusion: Following the removal of the foreign body, empirical antibiotic treatment with coverage against Gram-negative pathogens was initiated and later on replaced by appropriate antibiotics, after susceptibility testing is obtained.
- Técnica de mosaicoplastia no tratamento de lesões osteocondrais isoladas do côndilo femoral do joelho – estudo retrospectivoPublication . Karmali, Samir; Guerreiro, Rui; Costa, Daniel Sá da; Fonseca, Jorge; Gonçalves, RicardoObjetivo Lesões osteocondrais focais do joelho são encontradas em dois terços dos pacientes submetidos a artroscopia; seu tratamento, quando isoladas e, principalmente, em indivíduos jovens, ainda é debatido. O presente estudo analisa os resultados obtidos com a aplicação da técnica de mosaicoplastia no tratamento de lesões osteocondrais isoladas do côndilo femoral do joelho. Métodos Estudo retrospectivo de pacientes submetidos à mosaicoplastia e análise subjetiva com pontuações do International Knee Documentation Committee (IKDC, na sigla em inglês) antes e após a cirurgia. Resultados Um total de 13 casos, com média de idade de 34 anos; pacientes do sexo masculino (n ¼ 4; 31%) apresentaram média de idade de 23 anos (17–31 anos), e pacientes do sexo feminino (n ¼ 9; 69%) apresentaram média de 39 anos; (16–56 anos); femoral medial ou lateral (n ¼ 11, 85% versus n ¼ 2, 15%, respectivamente); o tamanho médio da lesão foi de 1,8 cm2 (0,6–4 cm); o tempo médio de acompanhamento foi de 5,045 +/- 3,47 anos (1,15–11,01 anos). A pontuação IKDC média préoperatória foi 31,63 pontos ( +/- 20,24), e a pós-operatória foi 74,18 pontos ( +/- 20,26). A diferença entre as pontuações IKDC obtidas depois e antes da cirurgia foi de 42,55 ( +/- 21,05) pontos, com o aumento mínimo de 8,1 pontos e o aumento máximo de 82,8 pontos. Uma diferença estatística significativa (p < 0,001) foi encontrada entre a pontuação IKDC antes e após a cirurgia. Uma relação estatisticamente significativa (p ¼ 0,038) foi observada entre o aumento da pontuação IKDC (a diferença entre a pontuação pré- e pós-operatória) e as dimensões da lesão.
- Trabalho Livre nº 35 - Práticas de Notificação e Prevenção de UPP: a experiência de uma unidade de MedicinaPublication . Guerreiro, Rui; Diniz, Ana; Miranda, Marta; Henriques, Solange; Costa, JoséA prevalência de úlceras por pressão (UPP) nos serviços de medicina é elevada, sendo recomendado o desenho de intervenções preventivas. Decorrente do processo de implementação do sistema de notificação de incidentes de segurança do doente no CHULC, a unidade de Medicina 1.2, notifica incidentes de UPP intra e extra-hospitalares desde 2008. Neste sentido, tem desenvolvido estratégias relativas à análise das práticas de prevenção, tal como recomendado no 7º objectivo estratégico do PNSD 2015-2020.