EM - Egas Moniz School of Health & Science
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A Egas Moniz School of Health & Science, entidade instituidora do Instituto Universitário Egas Moniz (anteriormente designado Instituto Superior de Ciências da Saúde Egas Moniz) e da Escola Superior de Saúde Egas Moniz (Politécnico), é uma instituição de ensino de referência dedicada à formação de profissionais de saúde, assumindo-se igualmente como um pólo de responsabilidade social fortemente inserido na comunidade local através da prestação de cuidados de saúde.
Enquanto instituição académica, desenvolve atividade pedagógica e científica, contando com um corpo docente altamente qualificado e participando em projetos de investigação científica desenvolvidos em parceria com instituições nacionais e estrangeiras.
O presente repositório visa colecionar, preservar e disponibilizar o acesso à produção científica da comunidade académica da Egas Moniz, contribuindo simultaneamente para o aumento da sua visibilidade e impacto no contexto da transferência de conhecimento.
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Browsing EM - Egas Moniz School of Health & Science by Field of Science and Technology (FOS) "Ciências Médicas"
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- The 2018 periodontitis case definition improves accuracy performance of full-mouth partial diagnostic protocolsPublication . Botelho, João; Machado, Vanessa; Proença, Luís; Mendes, José JoãoWe aimed to compare the accuracy performance of the new 2018 periodontitis case definition by the European Federation of Periodontology (EFP)/ American Association of Periodontology (AAP) with Centers for Disease Control (CDC)/AAP 2012 in full-mouth partial recording protocols (PRP). Retrospective data from NHANES 2011-2012 and 2013-2014 were analyzed. For each case definition, full-mouth diagnostic was defined as the reference standard. Patients were diagnosed for the presence of periodontitis and staging for each PRP. Sensitivity, specificity, accuracy and precision, through several indicators, were determined. Performance measurement was assessed through binary and multiclass ROC/AUC analyses. Our performance analysis shows that the new 2018 classification outperforms the 2012 classification regarding the diagnosis and staging of periodontitis on full-mouth PRPs. This recent case definition has strengthened the utility of PRPs and its improvements certainly explain the observed findings. Also, our findings contribute to the reliability of PRPs and its use in future worldwide epidemiological surveys.
- Accuracy of panoramic radiograph for diagnosing periodontitis comparing to clinical examinationPublication . Machado, Vanessa; Proença, Luís; Morgado, Mariana; Mendes, José João; Botelho, JoãoIn this study, we explore the diagnostic accuracy of a Radiographic-based Periodontal Bone Loss (R-PBL) method as a screening tool for periodontitis, in the form of radiographic bone loss, under the 2018 case definition in comparison to the 2012 case definition. The analysis was based on 456 patients (253 females and 203 males), screened for periodontal status in the Study of Periodontal Health in Almada-Seixal (SoPHiAS) project and subjected to a panoramic dental X-ray. Patients were diagnosed for the presence of periodontitis following the 2018 and 2012 case definition. R-PBL classification was defined by alveolar bone loss and diagnosed as no periodontitis (≥80% remaining alveolar bone), mild to moderate periodontitis (66% to 79%), or severe periodontitis (<66%). We appraise the X-ray quality to look for the influence on the performance of R-PBL. Sensitivity, specificity, accuracy, and precision, through several indicators, were determined. Performance measurement was assessed through binary and multiclass Receiver operating characteristic/are under the curve (ROC/AUC) analyses. Our results show that the tested R-PBL method under the 2018 case definition is a reliable tool in periodontitis cases screening. This method does not replace clinical periodontal evaluation, but rather, it screens patients towards a definitive periodontitis diagnosis. These results will contribute to support the development of automated prediction systems towards periodontitis surveillance.
- Analysis of the characteristics and cytotoxicity of titanium dioxide nanomaterials following simulated in vitro digestionPublication . Bettencourt, Ana; Gonçalves, Lídia M.; Gramacho, Ana C.; Vieira, Adriana; Rolo, Dora; Martins, Carla; Assunção, Ricardo; Alvito, Paula; Silva, Maria João; Louro, HenriquetaSeveral metallic nanomaterials (NMs), such as titanium dioxide nanomaterials (TiO2), present beneficial properties with a broad range of innovative applications. The human population is exposed to TiO2, particularly by ingestion, due to its increasing use as a food additive and inclusion in dietary supplements and food packaging materials. Whether this oral exposure may lead to adverse local or systemic outcomes has been the subject of research, but studies have generated contradictory results, reflecting differences in the physicochemical properties of the TiO2 studied, effects of the surrounding matrix, and modifications during digestion. This work aimed to investigate the toxic effects of three different TiO2 NMs (NM-103, NM-103 and NM-105) on the gastrointestinal tract cells, Caco-2 and HT29-MTX-E12, after the use of the standardized static INFOGEST 2.0 in vitro digestion method to mimic human digestion of TiO2, contributing to hazard assessment. The results show that, for one of the digested TiO2 NMs studied (NM-105), a more pronounced toxicity occurs after exposure of HT29-MTX-E12 intestinal cells, as compared to undigested NM, concomitantly with subtle changes in characteristics of the NM. Thus, the inclusion of the digestion simulation in the safety evaluation of ingested NMs through in vitro bioassays can better integrate the modifications that NMs suffer in the organism. It is expected that such an approach will reduce uncertainties in the hazard assessment of ingested NMs for human health.
- Anemia and hematopoietic factor deficiencies in patients after endoscopic gastrostomy: a nine-year and 472-patient studyPublication . Brito, Mariana; Laranjo, Ana; Nunes, Gonçalo; Oliveira, Cátia; Santos, Carla Adriana; Fonseca, JorgeIntroduction and aims: Patients undergoing percutaneous endoscopic gastrostomy (PEG) may present protein-energy malnutrition, anemia and deficiencies of hematopoietic factors, e.g., iron, folate and vitamin B12. There are no comprehensive studies on anemia or other hematological changes in PEG-patients. Our aim was to evaluate the hematological status of dysphagic patients that had undergone PEG and its association with clinical outcome. Methods: This research comprises a retrospective study of patients followed by our Artificial Feeding Team, submitted to PEG from 2010 to 2018. Patients were divided into two etiological groups: neurological dysphagia (ND) and head/neck or esophageal disorders (HNE). Laboratory data included serum albumin, hemoglobin, mean corpuscular volume, ferritin, transferrin, iron, vitamin B12 and folate. Survival after PEG was recorded in months, until death or December 2018. Results: We evaluated 472 patients; 250 (53%) presented anemia at the moment of gastrostomy, mostly normocytic (n = 219), with laboratory data suggestive of anemia of chronic disease (ACD). Six patients (1.3%) presented vitamin B12 deficiency and 57 (12.1%) presented folate deficit. No statistically significant difference in hemoglobin was found between the etiological groups (p = 0.230). Folate and vitamin B12 levels were lower in the HNE group (p < 0.01). A positive correlation between hemoglobin and survival was present (p < 0.01, r = 0.289), and hemoglobin levels were lower in the deceased population (p < 0.01). Conclusion: Anemia is frequent in PEG-patients, mostly with the features of ACD or multifactorial. It is associated with significant decrease in survival and may be viewed as a marker of severe metabolic distress, signaling poor outcome.
- Association between periodontitis and high blood pressure: results from the study of periodontal health in Almada-Seixal (SoPHiAS)Publication . Machado, Vanessa; Aguilera, Eva Muñoz; Botelho, João; Hussain, Syed Basit; Leira, Yago; Proença, Luís; D’Aiuto, Francesco; Mendes, José JoãoPeriodontitis is a common chronic inflammatory disease which could have an important impact on blood pressure (BP). This study aimed to explore (a) the association between periodontal health and BP in a large representative cohort, (b) the predictive value of diagnosis of periodontitis in undiagnosed raised BP and (c) whether age is a mediator of this relationship. In total, 1057 randomly recruited individuals (mean age, 60.9 ± 16.3 years, 57.7% women) underwent periodontal clinical assessment and one-single BP measurement using an automated sphygmomanometer device. Logistic and linear regression models were used to estimate the odds of hypertension based on periodontitis case definitions. Mediation analysis was performed to understand the effect of age on the association of periodontitis with hypertension. Adjusted logistic model for gender, smoking habits and body mass index confirmed the association between high BP and periodontitis (OR = 2.31, 95%CI: 1.75–3.04, p < 0.001). Among 168 participants with undiagnosed high BP (15.9% of the study sample), 62.5% had periodontitis (n = 105). In this study, the association between periodontitis with both systolic blood pressure (SBP) (77.6%, p < 0.001) and diastolic blood pressure (DBP) (66.0%, p < 0.001) was mediated by age. Periodontitis is closely linked to BP in a representative Portuguese population.
- Association between stress/anxiety, depression, pain and quality of life in people with chronic kidney diseasePublication . Sousa, Luís; Valentim, Olga; Marques-Vieira, Cristina; Antunes, Ana Vanessa; Severino, Sandy; José, HelenaBACKGROUND: Chronic kidney disease patients undergoing hemodialysis have a high symptom burden that contributes to increased suffering and diminishes their quality of life. Cardiovascular, musculoskeletal and psychosocial disorders affect their physical and functional capacity anxiety, stress and depression. AIM: To determine the prevalence of stress/anxiety and depression in people with chronic kidney disease and to verify the association between stress/anxiety and depression with pain and quality of life. METHODS: A cross-sectional, descriptive and correlational study; A random sample of 183 patients who underwent hemodialysis; application of the depression and stress anxiety scale (DASS-21), brief pain inventory (BPI), and Medical Outcomes Study Short-Form 12-Item Health Survey (SF-12). RESULTS: The sample consisted mostly of men (59.6%), married (53.8%), Portuguese nationality (78.7%), mean age 59.17 years (SD ± 14.64), hemodialysis treatment 70.9 months (SD ± 54.2). 76% were retired and 24% had a regular job. The prevalence of stress and anxiety was 24% and depression was 37.2%. CONCLUSIONS: Stress / anxiety and depression are prevalent in people with chronic kidney disease. Stress / anxiety and depression are associated with high levels of pain, which impacts on activities of daily living, presenting low levels of quality of life in the physical and mental components.
- Auditory and visual external cues have different effects on spatial but similar effects on temporal measures of gait variabilityPublication . Vaz, João R.; Rand, Troy; Fujan-Hansen, Jessica; Mukherjee, Mukul; Stergiou, NickWalking synchronized to external cues is a common practice in clinical settings. Several research studies showed that this popular gait rehabilitation tool alters gait variability. There is also recent evidence which suggests that alterations in the temporal structure of the external cues could restore gait variability at healthy levels. It is unknown, however, if such alterations produce similar effects if the cueing modalities used are different; visual or auditory. The modality could affect gait variability differentially, since there is evidence that auditory cues mostly act in the temporal domain of gait, while visual cues act in the spatial domain of gait. This study investigated how synchronizing steps with visual and auditory cues that are presented with different temporal structures could affect gait variability during treadmill walking. Three different temporal structured stimuli were used, invariant, fractal and random, in both modalities. Stride times, length and speed were determined, and their fractal scaling (an indicator of complexity) and coefficient of variation (CV) were calculated. No differences were observed in the CV, regardless of the cueing modality and the temporal structure of the stimuli. In terms of the stride time’s fractal scaling, we observed that the fractal stimulus induced higher values compared to random and invariant stimuli. The same was also observed in stride length, but only for the visual cueing modality. No differences were observed for stride speed. The selection of the cueing modality seems to be an important feature of gait rehabilitation. Visual cues are possibly a better choice due to the dependency on vision during walking. This is particularly evident during treadmill walking, a common practice in a clinical setting. Because of the treadmill effect on the temporal domain of gait, the use of auditory cues can be minimal, compared to visual cues.
- Bridging generations through integrative learning, research, and community care : The ESPIEM ProjectPublication . Auxtero, Maria Deolinda; Costa, Isabel Margarida; Brito, José; Figueiredo, Alexandra; Ascenso, Carla; Miranda, Margarida; Caneiras, Cátia; Fernandes, Ana IsabelCommunication abstract presented at the EAFP Annual Conference 2025 – “Pharmaceutical Education & Research: SWOT Analysis”. Faculty of Pharmacy, University of Coimbra, 13th-15th of May 2025
- Comparison of pain perception between clear aligners and fixed appliances: a systematic review and meta-analysisPublication . Pereira, Dinis; Machado, Vanessa; Botelho, João; Proença, Luís; Mendes, José João; Delgado, Ana SintraWe aimed to compare the pain discomfort levels between clear aligners and fixed appliances at multiple time points. Four electronic databases (Pubmed, Medline, CENTRAL and Scholar) were searched up to May 2020. There were no year or language restrictions. Randomized clinical trials and case–control studies comparing pain perception through pain visual analog scale (VAS) in patients treated with clear aligners and with fixed appliances were included. Risk of bias within and across studies was assessed using Cochrane tool and Newcastle–Ottawa Scale (NOS) approach. Random-effects meta-analysis were conducted. VAS score and analgesic consumption were collected. Random-effects meta-analyses were used to synthesize available data. Following the review protocol, five articles met the inclusion criteria and were included, with a total of 273 participants (177 females, 96 males). Overall, clear aligners were associated with significantly less pain than fixed appliances during the first seven days of orthodontic treatment. Patients treated with clear aligners experience less pain discomfort than those treated with fixed appliances and consume less analgesics, with SORT A recommendation.