Browsing by Author "Monteiro, M"
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- Complete blood count parameters as biomarkers of retinopathy of prematurity: a Portuguese multicenter studyPublication . Fevereiro-Martins, M; Santos, AC; Marques-Neves, C; Guimarães, H; Bicho, M; Afonso, C; Ferreira, J; Espírito Santo, R; Teixeira, F; Rosa, R; Carneiro, CV; Ferreira, M; Matos, T; Neiva, L; Pereira, S; Aires, S; Parreira, R; Melnik, Z; Faria, J; Teixeira, J; Barros, P; Almeida, J; Malheiro, B; Rodrigues, PC; Albuquerque, L; Freitas, A; Barros, P; Kotchekova, N; Freitas, R; Silveira, AC; Ferreira, A; Morais, B; Teixeira, S; Mota, M; Guerra, M; Coimbra, L; Gigante, J; Ferreira, M; Lapa, P; Monteiro, M; Alfaiate, M; Rodrigues, T; Pina, T; Rosário, M; Silva, R; Breda, J; Bazenga, F; Pinto, JAPurpose: To evaluate complete blood count (CBC) parameters in the first week of life as predictive biomarkers for the development of retinopathy of prematurity (ROP). Methods: Multicenter, prospective, observational study of a cohort of preterm infants born with gestational age (GA) < 32 weeks or birth weight < 1500 g in eight Portuguese neonatal intensive care units. All demographic, clinical, and laboratory data from the first week of life were collected. Univariate logistic regression was used to assess risk factors for ROP and then multivariate regression was performed. Results: A total of 455 infants were included in the study. The median GA was 29.6 weeks, and the median birth weight was 1295 g. One hundred and seventy-two infants (37.8%) developed ROP. Median values of erythrocytes (p < 0.001), hemoglobin (p < 0.001), hematocrit (p < 0.001), mean corpuscular hemoglobin concentration (p < 0.001), lymphocytes (p = 0.035), and platelets (p = 0.003) of the group of infants diagnosed with ROP any stage were lower than those without ROP. Mean corpuscular volume (MCV) (p = 0.044), red blood cell distribution width (RDW) (p < 0.001), erythroblasts (p < 0.001), neutrophils (p = 0.030), neutrophils-lymphocytes ratio (p = 0.028), and basophils (p = 0.003) were higher in the ROP group. Higher values of MCV, erythroblasts, and basophils remained significantly associated with ROP after multivariate regression. Conclusion: In our cohort, the increase in erythroblasts, MCV, and basophils in the first week of life was significantly and independently associated with the development of ROP. These CBC parameters may be early predictive biomarkers for ROP.
- Targeted temperature management to minimise secondary brain injury after cardiac arrest: A systematic reviewPublication . Seixas, JC; Oliveira, M; Monteiro, M; Pinto, MDR; Durão, C; Teixeira, G; Henriques, HR; Teixeira, JFBackground: A patient recovering from an in-hospital or out-of-hospital cardiac arrest (CA) requires interventions for recovery, particularly for minimising secondary brain injury. Targeted temperature management (TTM) is the intervention with the greatest impact on neurological recovery. Aim: The aim of this systematic review was to describe current TTM in adult CA patients and its impact on functional outcomes. Methods: This systematic review was developed between March and May 2024 according to the Joanna Briggs Institute guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for reporting. Eligibility criteria were established. We systematically reviewed studies enrolling adult CA patients who received TTM and reported functional outcomes. The search strategy was applied in the following databases: Medline and CINAHL Ultimate, the Cochrane Central Register of Controlled Trials, through EBSCO, and Scopus. The Rayyan software was used for the final extraction and selection. Results: The studies retrieved highlight the following interventions for neuroprotection: the use of a continuous temperature feedback system (continuous temperature monitoring with vesical, oesophageal, or parenthetic probes) for temperature induction; conducting a preinduction time between 390 min (6.5 h) and 12 h and an induction time greater than 440 min (7.3 h); setting the target temperature between 32 °C and 37.5 °C according to the patient's characteristics for a maintenance period between 24 and 48 h; the administration of sedatives, antipyretics, and neuromuscular blockers; and the assessment of neurological prognosis only after the rewarming phase, using scales such as the Cerebral Performance Category and the Modified Rankin Score. Conclusions: Continuous research and investment in this area of knowledge are highly encouraged, particularly in terms of refining accurate neurological prognostic tools and assessment scales.