EM - Artigos Científicos
Permanent URI for this collection
Browse
Browsing EM - Artigos Científicos by Field of Science and Technology (FOS) "Ciências Médicas::Medicina Básica"
Now showing 1 - 10 of 13
Results Per Page
Sort Options
- Adaptation and Validation of the Instrument ‘Children Care Quality at Hospital’ for PortuguesePublication . Loureiro, Fernanda; Araújo, Beatriz; Charepe, ZaidaObjective: adapt and validate the instrument Children Care Quality at Hospital (CCQH) to assess the quality of nursing care of hospitalized children for the Portuguese language of Portugal. Materials and Methods: content, language, and conceptual validity methodological study, with translation, feedback, and reflection. A non-probabilistic simple was used of 252 children between 7 and 11 years of age, hospitalized due to acute disease in nine services of six Portuguese hospitals. The reliability and validity of the results were determined to measure the psychometric properties of the instrument. Construct validity was calculated through exploratory factor analysis of main components with Varimax rotation and the internal consistency by determining the Cronbach’s alpha coefficient. Results: the internal consistency has adequate psychometric characteristics suitable for the Portuguese population (Cronbach’s alpha values between 0.66 and 0.82). The instrument maintained 49 items grouped into three categories: characteristics, activities, and environment. The psychometric characteristics of the CCQH, adapted and validated for Portuguese, guarantees its reliability and validity to measure satisfaction with the quality of nursing care from the perspective of school-aged children. Conclusions: the instrument could be used to assess children’s satisfaction with the quality of nursing care during their hospitalization.
- Are cariogenic bacteria the major risk factor to dental caries in patients with ulcerative colitis?Publication . Rodrigues, Eduardo; Laranjeira, Nuno; Nunes, Gonçalo; Roque-Ramos, Lídia; Vieira, Ana; Fonseca, JorgeBackground – High prevalence of dental caries in ulcerative colitis (UC) has been attributed to diet and changes in salivary environment. Objective – We aimed to characterize the prevalence of dental caries, salivary flow rates, salivary buffering capacity and cariogenic bacteria counts of Mutans streptococci and Lactobacillus spp and to evaluate their relationship with drug therapy, disease activity and duration. Methods – A cross-sectional study was performed with UC patients followed in a tertiary center. Participants were submitted to a questionnaire (including demographic data, oral hygiene, eating habits) and a clinical observation with assessment of plaque index and Decayed, Missing and Filled Teeth index. Unstimulated/stimulated saliva was collected. Medical records, disease activity (Partial Mayo Score) and disease duration were collected. Laboratory data included salivary flow rates, salivary buffering capacity (CRT® buffer) and cariogenic bacteria count (Mutans streptococci and Lactobacillus spp) in saliva using the CRT® bacteria test (results: high or low counts). Results – Thirty UC patients were recruited. Oral hygiene routines were daily teeth brushing once or more (96.7%) and fluoride toothpaste (73.3%). Decayed, Missing and Filled Teeth index (mean 16.17±6.428) was not affected by the frequency of soft drinks, cakes, sweets and sugars between meals (P>0.2). Long-term disease showed a trend towards higher prevalence of caries (P=0.06). Most presented normal salivary flow rates, unstimulated (73.3%) and stimulated (60.0%), and high salivary buffering capacity (66.7%). Any association was found with age, gender, disease activity, disease duration and drug therapy. High Mutans streptococci and low Lactobacillus spp count were observed in 73.3% and 60% of patients, respectively. Patients with active disease (100%) and longer duration (88.9%) displayed higher Mutans streptococci count. Conclusion – The prevalence of dental caries observed in UC patients was significant and did not seem to be influenced by their eating habits. The high prevalence of Mutans streptococci count may be a major risk factor for dental caries and may be looked as part of the UC dysbiosis. Dental care of UC patients should be planned according with this microbiota variation
- Beyond health : medicines, food supplements, energeticsand the commodification of self-performance in MaputoPublication . Rodrigues, Carla F.; Lopes, Noémia; Hardon, AnitaWith an increasing range of products in global and local markets, more options areavailable for individuals to enhance their image and their (cognitive, social and physical) performance. These ‘performance consumptions’ relate to ideals of well-being and improvement, and are based on constructed desires, expectations and needs that go beyond the (often blurred) dichotomy of health and illness. Drawingfrom mixed-methods research in Maputo, Mozambique, this paper discusses individuals’ use of medicines and other substances – pharmaceuticals, food supplements, traditional herbs, cosmetics and energy drinks – for managing different aspects of their everyday lives. Through an overview of the main consumption practices, we explore the underlying purposes and strategies of users, and the perceived legitimacy and risks involved when using a variety of products accessible through formal and informal exchange channels. From tiredness to sexual and aesthetic management, we show how the body becomes the locus of experimentation and investment to perform in accordance with socially expected roles, individual aspirations and everyday tasks. With insights from individuals’ accounts in Maputo, we aim to add to discussions on pharmaceuticalisation of body management by showing how the emergence of new performance consumptions is articulated with the reconfiguration of more ‘traditional’ consumption practices.
- Characterization of a large cluster of HIV-1 A1 infections detected in Portugal and connected to several Western European countriesPublication . Araújo, Pedro M. M.; Carvalho, Alexandre; Pingarilho, Marta; BEST-HOPE study group; Abecasis, Ana B.; Osório, Nuno S.HIV-1 subtypes associate with differences in transmission and disease progression. Thus, the existence of geographic hotspots of subtype diversity deepens the complexity of HIV-1/AIDS control. The already high subtype diversity in Portugal seems to be increasing due to infections with sub-subtype A1 virus. We performed phylogenetic analysis of 65 A1 sequences newly obtained from 14 Portuguese hospitals and 425 closely related database sequences. 80% of the A1 Portuguese isolates gathered in a main phylogenetic clade (MA1). Six transmission clusters were identified in MA1, encompassing isolates from Portugal, Spain, France, and United Kingdom. The most common transmission route identified was men who have sex with men. The origin of the MA1 was linked to Greece, with the first introduction to Portugal dating back to 1996 (95% HPD: 1993.6–1999.2). Individuals infected with MA1 virus revealed lower viral loads and higher CD4+ T-cell counts in comparison with those infected by subtype B. The expanding A1 clusters in Portugal are connected to other European countries and share a recent common ancestor with the Greek A1 outbreak. The recent expansion of this HIV-1 subtype might be related to a slower disease progression leading to a population level delay in its diagnostic.
- Dosing accuracy of oral extemporaneous suspensions of antibiotics: measuring procedures and administration devicesPublication . Neves, Inês; Auxtero, Maria Deolinda; Auxtero, Maria DeolindaExtemporaneous suspensions are often marketed with several administration devices that can be freely used by patients/caregivers. The homogeneity of suspensions requires shaking before use. Hence, it is crucial to assess the precision of all devices and the users’ awareness of the shaking procedure. This study was conducted at University Institute Egas Moniz with 40 pharmacy students who were asked to measure 2.5 and 5 mL of two extemporaneous azithromycin suspensions. Formulation A is marketed with a double-dosing spoon and oral syringe, whereas B includes a transparent dosing spoon. Both have a reconstitution cup. The user’s preference for administration devices, the degree of compliance with the ‘shake before use’ instruction and the accuracy of the manipulation were assessed. The double-dosing spoon was the preferred device. The “shake before use” instruction was overlooked by most volunteers. The average measured volumes obtained with the double-dosing spoon were significantly different from the ones obtained with the oral syringe (p < 0.001) and significantly lower than the reference dose (p < 0.001). The oral syringe originates significantly higher values than the reference dose (p < 0.001). The dosing spoons values were significantly different from each other (p < 0.001). Liquid medicines containing several administration devices may be a challenge since they are nonequivalent.
- My tooth is ill: (un)healthy tooth profiles among children (phase I and II)Publication . Dias, Maria do Rosário; Evangelista, José Grillo; Neves, Ana CristinaDental caries has been considered a public health problem insofar as it constitutes a source of burden, pain, and aesthetics with implications for the general well-being of the individual. It is essential to understand, analyse and characterize the mental representation of children about this concept, to contribute to the (re)conceptualization of oral health education in terms of the aetiology of caries. Two studies (Phase I and II) were carried out with the aim of characterizing the mental representation of an (Un)Healthy Tooth, associated with the concept of dental caries mentally internalized by children. This paper presents the results of an exploratory study divided into two distinct phases (Phase I: n = 880/4 - 9 years; Phase II: n = 812/6 - 12 years) that involved a total of 1692 children, recruited at the schools of the municipality of Lisbon and at Egas Moniz University Clinic. Data was collected for two moments: M1, where the child was asked to draw a healthy tooth on a sheet of paper and M2, where the child was asked to draw an unhealthy tooth on another sheet using only a pencil of graphite, totalling 3384 drawings. Subsequently, the child was asked to answer to an open-ended questionnaire, composed by three different questions, with the aim to evaluate the mental representation of the concept of: a) Dental decay, b) Healthy tooth and c) Unhealthy tooth. In the data from the content analysis of the drawings, that has been made by 4 - 12 year-old children, the symbolism category of the teeth that were drawn, tends to increase with chronological age between 4 - 6 years old, denoting a higher frequency of an unrealistic teeth category, drawn from phase I to phase II, and at the same time from 10 years old onwards there is a marked decrease in this pictorial (Un)Realism. Most children in both phase I and phase II associate a healthy tooth with a clean tooth with a smooth surface; In contrast, to the mental representation of an unhealthy tooth in both phases, in which the caries category is represented at the level of the categories: Stains, fractures and cavitation. Analysis of the pictorial contents of the drawings made by the participating children denotes significant discrepancies, inherent to the illustration profiles of healthy tooth versus unhealthy tooth. Such discrepancies bear implications at the level of oral health promotion and prevention, suggesting the need to create ludic-pedagogic instruments for oral health education in very early development stages.
- An overview of Portugal's educational challenges and responses to the global pandemic of COVID-19Publication . Costa, Filipa Alves da; Auxtero, Maria Deolinda; Martins, Ana Paula; Caramona, Maria MargaridaThe current pandemic of SARS-CoV-2 came un-expectantly and required unprecedented ability to adapt and quickly put in place the most appropriate response measures to limit the spread of COVID-19 disease, while minimising disruption to society’s essential activities. Some sectors were more capable of adapting and reacting than others. Higher education was one of the sectors where the academic capacity (FIP Development Goal 1) demonstrated was phenomenal, partially attributable to the ability to create partnerships between academia and practice. This editorial provides a description of the major changes put in place in Portugal to ensure the education and training of future graduates in Pharmaceutical Sciences was maintained with the same quality. It also discusses some of the potentially less beneficial long-term impacts of these adaptions to the teaching and assessment methods for the competencies of the workforce of tomorrow.
- A peri-implant disease risk score for patients with dental implants: validation and the influence of the interval between maintenance appointmentsPublication . Nobre, Miguel de Araújo; Salvado, Francisco; Nogueira, Paulo; Rocha, Evangelista; Ilg, Peter; Maló, PauloBackground: There is a need for tools that provide prediction of peri-implant disease. The purpose of this study was to validate a risk score for peri-implant disease and to assess the influence of the recall regimen in disease incidence based on a five-year retrospective cohort. Methods: Three hundred and fifty-three patients with 1238 implants were observed. A risk score was calculated from eight predictors and risk groups were established. Relative risk (RR) was estimated using logistic regression, and the c-statistic was calculated. The effect/impact of the recall regimen (≤ six months; > six months) on the incidence of peri-implant disease was evaluated for a subset of cases and matched controls. The RR and the proportional attributable risk (PAR) were estimated. Results: At baseline, patients fell into the following risk profiles: low-risk (n = 102, 28.9%), moderate-risk (n = 68, 19.3%), high-risk (n = 77, 21.8%), and very high-risk (n = 106, 30%). The incidence of peri-implant disease over five years was 24.1% (n = 85 patients). The RR for the risk groups was 5.52 (c-statistic = 0.858). The RR for a longer recall regimen was 1.06, corresponding to a PAR of 5.87%. Conclusions: The risk score for estimating peri-implant disease was validated and showed very good performance. Maintenance appointments of < six months or > six months did not influence the incidence of peri-implant disease when considering the matching of cases and controls by risk profile.
- Presence of gluten and soy derived excipients in medicinal products and their implications on allergen safety and labelingPublication . Figueiredo, Alexandra; Auxtero, Maria Deolinda; Brás, Adriana; Casimiro, Andreia; Costa, Isabel MargaridaGluten and soy allergies are significant health concerns, particularly in individuals with celiac disease or soy sensitivity. While dietary sources of these allergens are well-studied, their presence in medicinal products remains under-explored. This study assessed the prevalence of gluten and soy-derived excipients in 308 medicinal products authorized for marketing in Portugal. A systematic search of the Summary of Product Characteristics (SmPC) database was conducted for 108 analgesics and antipyretics containing paracetamol, 85 NSAIDs containing ibuprofen, and 115 antiasthmatic and bronchodilator medicinal products. The study found significant associations between pharmacotherapeutic groups and the presence of these allergens (p < 0.001). Gluten was more prevalent in the group of analgesics and antipyretics (44.4%) than in NSAIDs (8.2%), whereas soy-derived excipients were more frequent in NSAIDs (14%) than in analgesics and antipyretics (6.5%). No excipients containing gluten or soy were identified in antiasthmatic and bronchodilator medicinal products. In analgesics and antipyretics, 51.2% of solid oral dosage forms and 40% of liquid oral formulations contained gluten. Within the NSAIDs group, gluten was mainly present in liquid oral dosage forms (26.7%). Soy-derived excipients were found in 30% of liquid oral formulations and in 33.3% of rectal dosage forms of analgesics and antipyretics. In the NSAIDs group, soy was more prevalent in liquid oral formulations (26.7%). These findings highlight the need for clearer labeling of allergens in medicinal products and underscore the importance of vigilance for patients with gluten or soy allergies. Further research is required to address gaps in allergen disclosure by pharmaceutical manufacturers and to promote safer medicinal product use for sensitive populations. Enhanced awareness among healthcare providers and patients is essential to mitigate the risk of allergic reactions associated with hidden excipients in medicinal products.
- A prevenção quaternária e o iceberg das pseudo–doenças, incidentalomas e afinsPublication . Antunes. Júlia Maria Guilherme RibeiroO mar de pseudo-doenças, incidentalomas, anormalidades e disfunções, parece não ter fim, bem como os meios de diagnóstico cada vez mais sofisticados, mais sensíveis, sem correlação com sintomas clinicos, queixas subjectivas, ou história natural da doença, tem sido chamado “reservatório de doenças ou pseudo doenças” e parece alimentar produtos, serviços e tecnologias com grande impacto nas economias do nosso tempo. Apesar da procura da saúde perfeita, tornada moda e obrigação cívica, escrutinando permanentemente doenças hipotéticas e factores de risco que as ampliam enormemente, subjectivamente, as pessoas sentem–se mais doentes ! Barski, em 1988, chamou-lhe o “paradoxo da saúde”! A intensa medicalização da vida diária, acaba por transformar gente saudável em doentes crónicos ! A Medicina Preventiva, actual, é bastante diferente daquela que existiu no séc. XX, muito ampliada pelos medos, alinha-se com a industria da saúde num sem fim de exames, actos clinicos, observações que alimentam mercados que valem biliões de dolares como os da da ritalina e oxycodona! A prevenção quaternária veio nos últimos anos dar uma esperança a todos aqueles que desejam um outro olhar para a problemática da saúde/ doença.