Browsing by Author "Silva, Andreia"
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- A actividade física na gravidez: intervenção do enfermeiro.Publication . Butes, Lara; Marinho, Sara; Silva, Andreia; Marques, Fernanda Maria Gomes da Costa Teixeira; RAMOS, Ana Lúcia
- Congenital anomalies of the coronary arteriesPublication . Silva, Andreia; Baptista, Maria João; Araújo, EmanuelCongenital coronary artery anomalies are modifications of their origin, course or structure and its incidence varies between 0,2 and 5,6% of the general population. Although the majority is asymptomatic, they are the second leading cause of sudden cardiac death in young athletes. The aim of this study is to highlight the main anomalies with hemodynamic significance, including the anomalous origin of a coronary artery from the opposite sinus and anomalous origin of the left coronary artery from pulmonary artery. The anomalous aortic origin of a coronary artery from the opposite sinus accounts for 14-16% of all cardiac deaths, that unexpectedly occur in healthy children or young athletes during or immediately after exercise. The mechanism responsible for the compression/occlusion of the coronary artery originating from the opposite sinus is still unclear and there are several proposed mechanisms. The clinical presentation of these patients is variable and physical examination is normal in most individuals. Transthoracic echocardiogram is the diagnostic test most commonly used. Treatment and management are controversial topic. The anomalous origin of the left coronary artery from pulmonary artery is a very rare condition and without surgery, most infants die within the first 12 months of life. The echocardiogram is also the method of choice for diagnostic confirmation. The diagnosis of this congenital anomaly in an infant, usually seriously ill, is an indication for urgent surgery. Because these anomalies produce hemodynamic changes, it is important an early diagnosis and treatment.
- Ebola impact on african health systems entails a quest for more international and local resilience: the case of african portuguese speaking countriesPublication . Lapão, Luís Velez; Silva, Andreia; Pereira, Natália; Vasconcelos, Paula; Conceição, CláudiaIntroduction: Ebola epidemics have shown to have significant impacts on many aspects of healthcare systems. African countries have been facing many difficulties while addressing Ebola epidemics, moreover due to both lack of resources and fragmented involvement of national and international entities. The participation of multiple organizations has created serious problems of coordination of aid and the operation of that aid on the ground. This paper aims at addressing the impact of Ebola epidemics on African health systems, with a special focus on the definition of impact mitigation guidelines and the role of resilience. The example of Portuguese speaking countries is presented. Methods: a combination of literature review and case study methods are used. A literature review on Ebola outbreak impact on health systems will provide information to define a set of guidelines for healthcare services response to Ebola. The role of cooperation in providing additional resilience is described. Finally a case study focusing on the Portuguese collaboration and intervention in African Portuguese Speaking Countries (PALOP) is presented, as an example how the international community can provide additional resilience. Results: the existing knowledge is very helpful to guide both the preparation and the coordination of Ebola preparedness interventions. Additional resilience can be provided by international cooperation. Conclusion: in addition to international concrete support in times of crisis, to have a regional strategy of creating (multi-national) teams to rapidly implement an intervention while establishing better regional capacity to have sufficient resources to support the “resilience” required of the health system.
- O estudo de gravuras rupestres em blocos de edificados: o exemplo de Cilhades (Trás-os-Montes, Portugal)Publication . Silva, Andreia; Figueiredo, Sofia Soares
- As gravuras rupestres de Crestelos (Trás-os-Montes, Portugal) e a sua longa diacronia desde a Idade do Ferro ao Período ContemporâneoPublication . Silva, Andreia; Xavier, Pedro; Figueiredo, Sofia Soares
- Impact of Pancreatic Autoantibodies in Pancreas Graft Survival After Pancreas-Kidney TransplantationPublication . Pestana, Nicole; Malheiro, Jorge; Silva, Filipa; Silva, Andreia; Ribeiro, Catarina; Pedroso, Sofia; Almeida, Manuela; Dias, Leonídio; Henriques, António Castro; Martins, La SaleteIn simultaneous pancreas-kidney transplantation (SPKT), persistence or recurrence of pancreatic autoantibodies (PAs) has been associated with pancreas graft (PG) autoimmune-driven injury. Our aim was to analyze the impact of PAs on PG survival.Methods. Between January 1, 2000, and December 31, 2017, we studied 139 patients with post-SPKT antieglutamic acid decarboxylase (GAD) autoantibody. Alloimmune (ALI) events were defined as PG rejection and/or de novo donor-specific antibodies (DSA).Hence, 3 groups were defined: patients without ALI events or anti-GAD (n ¼ 42), those with ALI events (n ¼ 14), or those only with autoimmune events (positive for anti-GAD and no ALI events; n ¼ 83). Results. Male sex was predominant (n ¼ 72, 52%). Median age was 35 years (interquartile range: 31-39) and median follow-up was 6-7 years (interquartile range: 4.1-9.2). Regarding anti-GAD positivity post-SPKT (n ¼ 90, 65%), no differences were observed concerning age, sex, anti-HLA antibodies, HLA mismatch number and de novo DSA. ALI events were present in 10% (n ¼ 14). PG survival 15 years post-SPKT was better in patients without immune events (96%) followed by those with ALI (69%) and autoimmune events (63%) (P ¼ .025). Anti-GAD was associated to higher annualized mean Hb1AC (P ¼ .006) and lower mean C-peptide (P ¼ .013). According to pre- and post-SPKT anti-GAD status, conversion from negative to positive was associated to worse (63%) 10-year PG survival (P ¼ .044), compared to persistence of negative (100%) or positive anti-GAD (88%). Anti-islet cell and anti-insulin autoantibodies had no impact. Conclusion. Anti-GAD presence post-SPKT was associated to higher pâncreas disfunction and lower PG survival. De novo anti-GAD seems to offer a particular risk of PG failure.
- Informar, quando?: análise de caso, princípios éticos, normas deontológicas e do direito.Publication . Butes, Lara; Galhanas, Dulce; Rodrigues, Miguel; Silva, Andreia; Deodato, Sérgio
- Saúde Sazonal: Inverno e Saúde. Plano de Contingência para Temperaturas Extremas AdversasPublication . Silva, Andreia; Freitas, Graça; Pereira, Natália; Valente, PaulaNo Outono/Inverno ocorrem com frequência temperaturas baixas e há um aumento da incidência das infeções respiratórias na população, maioritariamente devidas à epidemia sazonal da gripe. No entanto, outros agentes virais e bacterianos ocorrem em simultâneo com a gripe. A Direção-Geral da Saúde (DGS) promove a implementação, desde 2004, de Planos de Contingência com o objetivo de minimizar os potenciais efeitos do frio extremo na saúde da população. O Plano de Contingência para Temperaturas Extremas Adversas está enquadrado por normativos legais, reforçando a importância e a necessidade dos serviços e estabelecimentos do Serviço Nacional de Saúde (SNS) implementarem Planos de Contingência para Temperaturas Extremas Adversas. Tal como mencionado no Plano Verão e Saúde, também o Plano Inverno e Saúde (doravante designado por Plano) está incluído no Projeto Saúde Sazonal. Pretende-se desta forma valorizar a intervenção e comunicação contínuas, ao longo do ano, adaptando-as à sazonalidade e às suas especificidades.
- Saúde Sazonal: Verão e Saúde. Plano de Contingência para Temperaturas Extremas AdversasPublication . Silva, Andreia; Freitas, Graça; Pereira, Natália; Valente, PaulaPortugal é um dos países europeus vulneráveis às alterações climáticas e aos fenómenos climáticos extremos, tendo em conta a sua localização geográfica. Há dados sugerindo que há uma tendência para o aumento da temperatura média global assim como para o aumento do número de dias por ano com temperaturas elevadas. Na primavera/verão ocorrem, com frequência, temperaturas elevadas, podendo existir efeitos graves sobre a saúde, incluindo desidratação e descompensação de doenças crónicas. Nesta época são ainda relevantes os acidentes, os afogamentos, as toxinfeções alimentares, o aumento da população de vetores, nomeadamente mosquitos e carraças e os incêndios. O potencial aumento da morbilidade pode conduzir a um aumento da procura dos serviços de saúde.
- The Holocene transition and post-palaeolithic rock art from the Sabor Valley (Trás-os-Montes, Portugal)Publication . Figueiredo, Sofia Soares; Xavier, Pedro; Silva, Andreia; Neves, Dário; García, Isabel Domínguez