Browsing by Author "Pereira, Marta"
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- Contributo para a adaptação cultural e validação do Neck Disability Index para a língua portuguesa.Publication . Domingues, Lúcia; Susana, Duarte; Pereira, Marta; Carnide, Filomena; Fernandes, Rita; Cruz, Eduardo Brazete
- Editorial Debaixo d'água é chique: fotografia subaquática da marca fictícia mpPublication . Pereira, Marta; Costa, CarlosEste Projeto consiste na criação de um editorial de moda, no qual é recorrido à fotografia subaquática, onde pretende analisar e explorar a fotografia de moda subaquática através do corpo feminino debaixo de água, criando um diálogo visual através da mesma. Uma vez que a fotografia de moda subaquática não é muito explorada em Portugal, ou até mesmo de todo explorada, tornou-se um projeto interessante do ponto de vista curioso, trazendo assim conhecimento e criatividade a um tema já tão explorado como é a fotografia de moda. O conceito trazido então para este projeto é o de mostrar sem mostrar, do qual o vestuário apresentado foi trabalhado de forma a realçar a silhueta feminina, criando um ambiente de elegância e glamour, demonstrando sensualidade e desvendando partes do corpo após o contacto dos tecidos com a água.
- Obesity, acute kidney injury and mortality in patients with sepsis: a cohort analysisPublication . Gameiro, Joana; Gonçalves, Miguel; Pereira, Marta; Rodrigues, Natacha; Godinho, Iolanda; Neves, Marta; Gouveia, João; Silva, Zélia Costa e; Jorge, Sofia; Lopes, José AntónioAlthough the prognostic effect of obesity has been studied in critically ill patients its impact on outcomes of septic patients and its role as a risk factor for acute kidney injury (AKI) is not consensual. We aimed to analyze the impact of obesity on the occurrence of AKI and on in-hospital mortality in a cohort of critically ill septic patients. This study is retrospective including 456 adult patients with sepsis admitted to the Division of Intensive Medicine of the Centro Hospitalar Lisboa Norte (Lisbon, Portugal) between January 2008 and December 2014. Obesity was defined as a body mass index of 30 kg/m2 or higher. The Kidney Disease Improving Global Outcomes classification was used to diagnose and classify patients developing AKI. AKI occurred in 87.5% of patients (19.5% with stage 1, 22.6% with stage 2 and 45.4% with stage 3). Obese patients developed AKI more frequently than non-obese patients (92.8% versus 85.5%, p = .035; unadjusted OR 2.2 (95% CI: 1.04-4.6), p = .039; adjusted OR 2.31 (95% CI: 1.07-5.02), p = .034). The percentage of obese patients, however, did not differ between AKI stages (stage 1, 25.1%; stage 2, 28.6%; stage 3, 15.4%; p = .145). There was no association between obesity and mortality (p = .739). Of note, when comparing AKI patients with or without obesity in terms of in-hospital mortality there were also no significant differences between those groups (38.4% versus 38.4%, p = .998). Obesity was associated with the occurrence of AKI in critically ill patients with sepsis; however, it was not associated with in-hospital mortality.
- Serum lactates and acute kidney injury in patientsPublication . Gonçalves, Miguel; Gameiro, Joana; Pereira, Marta; Rodrigues, NatachaAbstract:Granting the association of lactates with mortality has been largely ocumented in critically ill patients with sepsis, its association with the development of acute kidney injury (AKI) in this setting is not well established. We aimed to analyze the association of serum lactates at intensive care unit (ICU) admission with the occurrence AKI in a cohort of critically ill septic patients. Materials and methods: This study is retrospective including 457 adult patients with sepsis admitted to the Division of Intensive Medicine of the Centro Hospitalar Lisboa Norte (Lisbon, Portugal) between January 2008 and December 2014. The Kidney Disease Improving Global Outcomes (KDIGO) classification was used to diagnose and classify patients developing AKI within the first week of hospitalization. Logistic regression analysis was employed to determine factors associated with AKI development. Data were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). Statistical significance was defined as a p-value < 0.05. Results: AKI occurred in 87.5% of patients with a maximum KDIGO category (19.5% with stage 1, 22.6% with stage 2 and 45.4% with stage 3). Serum lactates were higher among patients developing AKI as compared with non-AKI patients (mmol/L 29.9 ± 25.7 vs. 18.6 ± 9.3, p = 0.001; unadjusted OR 1.04 (95% CI 1.02–1.07), p = 0.001; adjusted OR 1.03 (95% CI 1.01–1.06), p = 0.024), and they were progressively higher in accordance with AKI severity (stage 1, 24.5 ± 18.7; stage 2, 25.5 ± 16.9; stage 3, 34.6 ± 30.7; p = 0.001). Conclusions: Serum lactates at ICU admission were independently associated with the occurrence of AKI in critically ill patients with sepsis.
- Traqueoesophageal fistula patients fed through percutaneous endoscopic gastrostomy/gastrojejunostomy: nutritional status and clinical outcomePublication . Santos, Carla Adriana; Pereira, Marta; Martins, Vera Santos; Fonseca, Jorge"BACKGROUND: tracheoesophageal fistula (TEF) may result from cancer or mechanical ventilation. Endoscopic Gastrostomy or Gastrojejunostomy (PEG/PEG-J) is used for nutritional support. OBJECTIVE: in TEF-patients, evaluating nutritional status when PEG is performed, safety of PEG/PEG-J and clinical outcome. METHODS: from the files of PEG/PEG-J feed TEF-patients we collected: clinical data, Body Mass Index, albumin, transferrin and cholesterol when gastrostomy was performed, and clinical outcome globally and according with the TEF cause: Group 1: complication of mechanical ventilation, Group 2: cancer. RESULTS: twelve patients, 18-91 years (median: 53), 11 PEG, one PEG-J: six complications of ventilation (neurological diseases), 6 cancers. Mean period from TEF diagnosis until gastrostomy: 2 months in Group 1, 10 months in Group 2. In the day of the gastrostomy, patients presented with malnutrition parameters, most strikingly in the cancer group. Group 1: died a single patient, 3 closed the TEF, resuming oral intake, 2 are still PEG-feed. All cancer patients died (7 months after gastrostomy). One needed a jejunal extension to create a PEG-J. No more complications. CONCLUSION: PEG/PEG-J was safe in TEF-patients, but cancer patients underwent gastrostomy too late. In TEF-patients, PEG/PEG-J should be considered in a regular basis, earlier in the disease evolution, before established malnutrition."