Browsing by Author "Marques, M"
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- Care causing diagnosis, comorbidities and nutritional status of patients in continuous long term care unitPublication . Marques, M; Gonçalves, V; Vieira, A; Magalhães, F; Godinho, J; Lemos, A; Costa, V; Faria, AnaIntroduction: Poor nutritional status has negative implications on prognosis, cost of care, morbidity and mortality. However, when nutritional assessment is not implemented, malnutrition can go untreated. Objectives: The aim of this study was to establish a relationship between care causing diagnosis, existing comorbidities and nutritional status of patients admitted to a long-term care unit. Methods: In the context of Nutrition Day audit, from 2016 to 2018, nutritional status was assessed using Mini Nutritional Assessment. Sociodemographic and anthropometric data, as well as medical history were collected. Results: Sixty-two individuals were included (51.6% male), with a mean age of 7711 years. Mean BMI was 22.94.3kg/m2. Most of the patients were bedridden or in wheelchair (51.6%). A great part of the sample was at risk of malnutrition (40.3%) and 27.4% was malnourished. The majority of the sample showed dementia (75.8%) and 66.2% had depression. A correlation was found between nutritional status and cognitive status(r = 0.445; p = 0.000); and between nutritional status and functional capacity(r = 0.284; p = 0.025). Care causing diagnosis for most of the patients was central nervous system disease (66.1%), followed by heart disease (59.7%), skeletal muscle disease (30.6%) and cancer (17.7%). An association was found between heart disease and malnutrition (p = 0.023). Almost all of the sample was polymedicated (91.9%) and most was taking antypsychotics and/or neuroleptics (71.0%). Conclusions: In this long-term care unit, malnutrition presented a significant prevalence. Cognitive status decline and low functional capacity seem to be correlated with a worse nutritional status. Also, heart disease was associated with malnutrition, meaning that these are significant risk factors for the development of malnutrition. Nutrition Day audit brings awareness to the importance of nutritional care, as well as the need for development of nutritional screening and assessment protocols.
- Epidemiological and Clinical Aspects of Cutaneous and Mucosal Leishmaniases in Portugal: Retrospective Analysis of Cases Diagnosed in Public Hospitals and Reported in the Literature between 2010 and 2020Publication . Rocha, R; Conceição, C; Gonçalves, L; Carvalho, AC; Maia, A; Martins, A; Carujo, A; Maio, A; Forra, C; Melita, C; Couto, D; Fernandes, D; Pereira, D; Leal, E; Sarmento, H; Sousa, I; Gonçalves, JP; Marinho, J; Vasconcelos, J; Cunha, J; Rodrigues, J; Silva, JM; Caley, L; Malheiro, L; Santos, L; Garcia, M; Cunha, M; Lima, M; Andrade, MM; Marques, M; Alpalhão, M; Silva, M; Ferraz, R; Soares, R; Fernandes, S; Llobet, S; Cruz, S; Guimarães, T; Branco, T; Robalo-Nunes, T; Almeida, V; Maia, CLeishmania infantum, a zoonotic vector-born parasite, is endemic in the Mediterranean region, presenting mostly as visceral (VL), but also as cutaneous (CL) and mucosal leishmaniasis (ML). This study aimed to describe the epidemiological and clinical aspects of the CL and ML cases diagnosed in mainland Portugal between 2010 and 2020. Collaboration was requested from every hospital of the Portuguese National Health System. Cases were screened through a search of diagnostic discharge codes or positive laboratory results for Leishmania infection. Simultaneously, a comprehensive literature search was performed. Descriptive statistics and hypothesis testing were performed using IBM® SPSS® Statistics. A total of 43 CL and 7 ML cases were identified, with a predominance of autochthonous cases (86%). In CL, immunosuppressed individuals constituted a significant proportion of patients (48%), and in this group, disseminated CL (22%) and simultaneous VL (54%) were common. In autochthonous cases, lesions, mostly papules/nodules (62%), were frequently observed on the head (48%). The approach to treatment was very heterogeneous. ML cases were all autochthonous, were diagnosed primarily in older immunosuppressed individuals, and were generally treated with liposomal amphotericin B. The findings suggest a need for enhanced surveillance and reporting, clinical awareness, and diagnostic capacity of these forms of leishmaniasis to mitigate underdiagnosis and improve patient outcomes. A holistic One Health approach is advocated to address the multifaceted challenges posed by leishmaniases in Portugal and beyond.
- Epidemiological and Clinical Aspects of Cutaneous and Mucosal Leishmaniases in Portugal: Retrospective Analysis of Cases Diagnosed in Public Hospitals and Reported in the Literature between 2010 and 2020Publication . Rocha, R; Conceição, C; Gonçalves, L; Carvalho, AC; Maia, A; Martins, A; Carujo, A; Maio, A; Forra, C; Melita, C; Couto, D; Fernandes, D; Pereira, D; Leal, E; Sarmento, H; Sousa, I; Gonçalves, JP; Marinho, J; Vasconcelos, J; Cunha, J; Rodrigues, J; Silva, JM; Caley, L; Malheiro, L; Santos, L; Garcia, M; Cunha, M; Lima, M; Andrade, MM; Marques, M; Alpalhão, M; Silva, M; Ferraz, R; Soares, R; Fernandes, S; Llobet, S; Cruz, S; Guimarães, T; Branco, T; Robalo-Nunes, T; Almeida, V; Maia, CLeishmania infantum, a zoonotic vector-born parasite, is endemic in the Mediterranean region, presenting mostly as visceral (VL), but also as cutaneous (CL) and mucosal leishmaniasis (ML). This study aimed to describe the epidemiological and clinical aspects of the CL and ML cases diagnosed in mainland Portugal between 2010 and 2020. Collaboration was requested from every hospital of the Portuguese National Health System. Cases were screened through a search of diagnostic discharge codes or positive laboratory results for Leishmania infection. Simultaneously, a comprehensive literature search was performed. Descriptive statistics and hypothesis testing were performed using IBM® SPSS® Statistics. A total of 43 CL and 7 ML cases were identified, with a predominance of autochthonous cases (86%). In CL, immunosuppressed individuals constituted a significant proportion of patients (48%), and in this group, disseminated CL (22%) and simultaneous VL (54%) were common. In autochthonous cases, lesions, mostly papules/nodules (62%), were frequently observed on the head (48%). The approach to treatment was very heterogeneous. ML cases were all autochthonous, were diagnosed primarily in older immunosuppressed individuals, and were generally treated with liposomal amphotericin B. The findings suggest a need for enhanced surveillance and reporting, clinical awareness, and diagnostic capacity of these forms of leishmaniasis to mitigate underdiagnosis and improve patient outcomes. A holistic One Health approach is advocated to address the multifaceted challenges posed by leishmaniases in Portugal and beyond.
- Multicenter survey on the use of device-assisted enteroscopy in PortugalPublication . Pinho, R; Mascarenhas-Saraiva, M; Mão-de-Ferro, S; Ferreira, S; Almeida, N; Figueiredo, P; Rodrigues, A; Cardoso, H; Marques, M; Rosa, B; Cotter, J; Vilas-Boas, G; Cardoso, C; Salgado, M; Marcos-Pinto, RDevice-assisted enteroscopies (DAEs) are recent endoscopic techniques that enable direct endoscopic small-bowel evaluation.
- Nutrition Day in nursing homes – risk factors for malnutritionPublication . Marques, M; Damas, M; Costa, E; Brás, M; Lemos, A; Costa, V; Faria, AnaIntroduction: Malnutrition in institutionalized older adults has a significant prevalence, and is associated with cognitive decline, higher morbidity and mortality rates. Objectives: The aim of this study was to assess risk factors for malnutrition in nursing home residents. Methods: Through Nutrition Day audit (2016–2018), demographic and anthropometric data was collected, as well as medical history and nutritional status according to Mini Nutritional Assessment. Results: Sixty-three individuals were included (57.1% male), with a mean age of 849 years. Mean Body Mass Index was 21.55.1 kg/m2. Malnutrition was identified in 47.6% of the patients and nutritional risk in 28.6%. Most of the sample (61.9%) was bedridden or in wheelchair. Most of the individuals showed dementia (82.5%) and depression (79.3%). A positive moderate significant correlation was found between nutritional status and cognitive status (r = 0.407;p=0.001); and between nutritional status and functional capacity (r = 0.474;p=0.000). Considering the diagnosis which caused institutionalization, brain pathologies were the most prevalent (79.4%), followed by cardiovascular diseases (49.2%) and skeletal muscle diseases (27.0%). Mean number of medications taken daily was 74 and 74.6% of the residents were polymedicated. The majority (61.9%) was taking antipsychotics and/or neuroleptics and 28.6% were taking antidepressives. Conclusions: In this sample, individuals are essentially older adults with a high prevalence of malnutrition. The high level of dependence and the presence of dementia are significant risk factors for the development of this condition. Disturbed emotional status and the use of multiple drugs associated with impaired appetite, although without statistically significant associations with nutritional status, are highly prevalent in this sample. Nutritional screening in this population is essential and timely necessary, aiming to prevent deterioration or improve nutritional status.
- Potenciais evocados motores em cirurgia da aorta toracoabdominalPublication . Magro, C; Nora, D; Marques, M; Alves, AGA patologia aórtica toracoabdominal (aneurisma ou disseção) tem tido uma incidência crescente nas últimas décadas. A cirurgia é o tratamento curativo, associando-se, porém, a uma elevada morbimortalidade perioperatória. A paraplegia é uma das mais severas complicações, cuja incidência tem diminuído significativamente com a implementação de estratégias de proteção medular. A patologia aórtica toracoabdominal (aneurisma ou disseção) tem tido uma incidência crescente nas últimas décadas. A cirurgia é o tratamento curativo, associando-se, porém, a uma elevada morbimortalidade perioperatória. A paraplegia é uma das mais severas complicações, cuja incidência tem diminuído significativamente com a implementação de estratégias de proteção medular. Nenhum método isolado ou combinação de métodos provou ser inteiramente eficaz na prevenção da paraplegia. Constituem objectivos desta revisão, uma análise da evidência científica sobre o papel da neuromonitorização intraopera- tória com potenciais evocados motores no prognóstico neurológico de doentes submetidos a cirurgia aórtica toracoabdominal. Procedeu-se a uma pesquisa bibliográfica online (PubMed). As referências consideradas relevantes foram seleccionadas e revistas. A neuromonitorização intraoperatória com potenciais evocados motores (PEM) permite a detecção atempada de eventos isquémicos espinhais e uma intervenção dirigida que impeça o desenvolvimento da lesão medular, reduzindo significativamente a incidência de paraplegia pós-operatória. A monitorização com PEM pode sofrer várias interferências intraoperatórias, com eventual compromisso da sua inter- pretação. O bloqueio neuromuscular é o principal factor limitante de origem anestésica. É essencial atingir um equilíbrio entre as condições de monitorização e as necessidades anestésico-cirúrgicas, bem como avaliar o risco e o benefício da técnica para cada doente. A neuromonitorização com PEM melhora o prognóstico neurológico, desde que integrada numa estratégia de actuação multidisciplinar, que envolva múltiplos mecanismos protectores e que se adeque à realidade hospitalar.