Percorrer por tipo de recurso "clinical study"
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- Anterior Cruciate Ligament Reconstruction Using a Tibial-Pedicled Quadrupled Semitendinosus Autograft With Dual Adjustable-Loop Cortical SuspensionPublication . Rodeia, J; Alçada, R; Baptista, F; Goes, RAnterior cruciate ligament reconstruction is one of the most commonly performed procedures in knee surgery. Despite its frequency, numerous technical variations exist, and several aspects remain controversial. Hamstring tendons are among the most frequently used autografts, and there is growing interest in techniques that preserve the gracilis tendon. Additionally, preservation of the tibial insertion of the hamstrings has recognized biological and mechanical advantages. In this technical note, we describe a technique that aims to combine the advantages of both approaches: the benefits of using a short single semitendinosus graft, preserving the gracilis tendon, which is associated with lower donor-site morbidity and improved flexion strength compared with traditional 2-tendon harvests, and the advantages of maintaining the tibial attachment of the semitendinosus, which include improved graft vascularization and a secondary point of tibial fixation. This method uses a tibial-pedicled, quadrupled semitendinosus graft combined with a dual adjustable-loop cortical suspension device. The technique is reproducible, is cost-effective, and may offer both biological and mechanical benefits over conventional approaches.
- Comportamentos Aditivos aos 18 anos - Inquérito aos Jovens Participantes no Dia da Defesa Nacional 2025: Utilização da InternetPublication . Ludmila, Carapinha; Calado, Vasco; Neto, Helena; ICAD, IPO inquérito sobre comportamentos aditivos aplicado aos jovens participantes no Dia da Defesa Nacional teve a sua edição nacional em 2015, sendo o presente estudo resultante da décima edição do mesmo. Durante o Dia da Defesa Nacional são desenvolvidas atividades destinadas a sensibilizar os jovens para a importância da Defesa Nacional e para o papel e missão das Forças Armadas Portuguesas. Estas atividades decorrem nos Centros de Divulgação do Dia da Defesa Nacional(CDDN) sedeados em unidades militares dos três Ramos das Forças Armadas em todo o país. Este inquérito está associado à participação de entidades públicas do setor da saúde, em particular, no domínio dos comportamentos aditivos, no programa de atividades do Dia da Defesa Nacional, que, para além da componente militar, abrange outro tipo de ações, designadamente nas áreas da saúde e educação. O presente inquérito permite analisar um conjunto restrito de indicadores relativos à utilização da internet, em geral, e quanto às redes sociais, qualquer jogo, jogo de apostas, pesquisas a ler e estudar e visualização de vídeos, filmes ou tutoriais. É possível constatar como a utilização da internet, designadamente para redes sociais, para pesquisas ou para vídeos, filmes ou tutoriais é praticamente universal entre os inquiridos. Por seu turno, em cada 10 jovens, 6 jogam online e 2 fazem-no a dinheiro (jogo de apostas. De referir que 4 em cada 10 declaram passar na internet durante 5 horas ou mais por dia. As plataformas em que os jovens passam mais tempo são as redes sociais, com 13% a mencionarem uma utilização diária de 6 ou mais horas, seguindo-se as pesquisas para ler ou estudar (7%), o jogo (6%) e a visualização de filmes, vídeos e tutoriais (6%). Perto de 4 em cada 10 jovens referem a experiência de problemas que associam à utilização da internet. Verifica-se um aumento dos jovens que iniciaram a utilização da internet com menos de 10 anos. Especificamente entre 2024 e 2025, sendo o quadro de estabilidade, predominam evoluções percentuais (sempre iguais ou inferiores a 1pp) no sentido da redução de uma utilização mais intensiva. A exceção reside no jogo de apostas, cuja utilização mais intensiva aumentou 1 pp.
- Dar Voz ao Território Psicotrópico: Estudo de Caracterização das Pessoas que Usam Drogas nos Projetos de RRMD do CRI Porto OcidentalPublication . Rodrigues, Sónia Carvalho, Patrícia João, Hélder São Oliveira, Pedro David; ICAD, I.P.Este relatório da responsabilidade do Centro de Respostas Integradas (CRI) Porto Ocidental, aborda questões no âmbito do consumo de substâncias psicoativas e das perturbações associadas ao seu uso que representam um desafio complexo à Saúde Pública, às politicas sociais e aos direitos humanos (Organização Mundial de Saúde (OMS), 2022). Estas perturbações caracterizam-se por padrões de consumo associadas a dependência e a disfunção biopsicossocial, afetando não apenas os indivíduos, mas também as suas famílias e comunidades. O Centro de Respostas Integradas (CRI) Porto Ocidental intervêm num território diverso - abrangendo as freguesias ocidentais da cidade do Porto e os concelhos da Maia, Matosinhos, Póvoa do Varzim, Vila do Conde, Santo Tirso e Trofa. Este documento resulta de um trabalho sistemático de recolha de dados entre 2003 e 2004, desenvolvido pelas equipas de RRMD e de uma análise aprofundada ao longo de 2025, com o objetivo de dar visibilidade às pessoas e aos contextos.
- The effects of hyperbaric oxygen therapy on insulin resistance-an approach to physiologyPublication . Sampaio-Alves, M; Alpuim Costa, D; Gomes-Alves, I; Neves, JSBackground: Diabetes mellitus (DM) is a severe, chronic and complex metabolic disease that leads to multiple dysfunctions, including micro and macrovascular complications, which are a major cause of morbidity and mortality. Type 2 DM (T2D) is highly preventable, and the stages that precede it are the ideal target for therapeutic intervention. Hyperbaric oxygen therapy (HBOT) is an established medical treatment for several clinical conditions. Because DM is one of the most prevalent comorbidities in patients under HBOT, it has allowed the observation and inference of some of its effects on DM, suggesting clinical benefit in different spectrums of the disease. Our main aim was to gather the existing evidence on the impact of HBOT on insulin resistance, as this is the best predictor for the development of T2D. Materials and methods: The scoping review was the methodology chosen to include all available data. Exclusion criteria consisted of articles that did not mention the effects of HBOT on insulin resistance, described only the use of normobaric oxygen, or had no available translation to English, Spanish, or Portuguese. In addition, all data discussing any effects on insulin, insulin resistance, or insulin sensitivity were included. Results: Two hundred and thirty studies were found, and 17 were eligible. The HBOT appears to improve fasting glycaemia and decrease insulin resistance in patients with DM, with effects appearing after 1 treatment session. Additionally, it reduces levels of proinflammatory cytokines that contribute to insulin resistance. The duration of this sensitisation effect remains unknown, as do the contributing molecular factors. Conclusion: HBOT seems to improve glycaemic levels and insulin sensitivity, thus presenting a potential treatment approach to treat insulin resistance and its consequences. However, translation into clinical practice remains contingent on robust, yet unavailable, randomized clinical trials.
- Estudo de Avaliação do Processo de Tratamento no âmbito dos Comportamentos Aditivos e Dependências - Vivências, percepções e significados dos utentes em processo de tratamento em CADPublication . Ribeiro, Andreia; ICAD, IPO presente estudo visa analisar as percepções dos utentes em tratamento no âmbito dos comportamentos aditivos e dependências, centrando-se nas continuidades e descontinuidades experienciadas nos serviços. Pretende-se, através das suas perspectivas sobre o processo de tratamento encontrar caminhos para a melhoria da qualidade e eficácia dos serviços especializados prestados pelo ICAD, IP.
- Extensive Myocardial Calcification Following Fulminant Neonatal Enteroviral MyocarditisPublication . Noites, I; Guedes, S; Ferreira, M; Camilo, C; Abecasis, FMyocardial calcification is a rare but important complication of fulminant neonatal myocarditis, a potentially life-threatening condition. Only a handful of neonatal cases have been reported in the literature. We present the case of a previously healthy seven-day-old term male neonate who developed cardiogenic shock secondary to enteroviral myocarditis with confirmed central nervous system involvement. Despite prompt initiation of inotropic therapy, he required venoarterial extracorporeal membrane oxygenation (VA-ECMO) within 48 hours of admission. While on mechanical circulatory support, serial imaging showed progressively increased myocardial echogenicity on echocardiography and later curvilinear myocardial calcification on chest radiograph. The clinical course was characterised by persistent cardiac dysfunction and progression to irreversible multiorgan failure. Heart transplantation was deemed unfeasible, and life-sustaining therapies were withdrawn, following multidisciplinary discussion and family consultation. An autopsy was not performed. This case highlights myocardial calcification as a potential imaging marker of irreversible myocardial injury in fulminant neonatal myocarditis. Early recognition of progressive myocardial echogenicity and subsequent calcification may provide valuable prognostic information, helping clinicians assess disease severity and support informed decision-making in cases of fulminant neonatal myocarditis.
- Fatores que Influenciam a Disfunção Sexual em Homens Submetidos a Terapêutica de Substituição com Opioides num Centro PortuguêsPublication . Alves, Tânia Patrícia Vasques; Freitas, Patrícia Jorge de Azevedo Barbosa Silveira Machado; CRI do Porto Central, Polo de CedofeitaEste artigo científico tem como objetivo avaliar a prevalência da disfunção sexual em homens a realizar terapia de substituição opiácea num centro português; quais os domínios da função sexual afetados; quais os fatores que influenciam a disfunção sexual. Participaram 82 pacientes. Encontravam-se em tratamento com metadona 80,5% com dose atual média de 53,5 mg por um tempo médio de 12,6 anos e com dose de 86,2 mg. Encontravam-se em tratamento com buprenorfina, 19,5% com dose atual média de 5,74 mg por um tempo médio de 10, 4 anos e dose máxima média de 8,07 mg. Relativamente ao tratamento psicofarmacológico, 23,8 tomavam antidepressivos e 14,8% tomavam antipsicóticos. Para além disso, 43,5% apresentavam ansiedade e 46,2% depressão. Neste estudo não foram encontradas evidências que justifiquem a substituição de metadona por buprenorfina em casos de disfunção sexual. A ansiedade e a depressão parecem ser os fatores mais correlacionados com a disfunção sexual e a disfunção erétil. O artigo científico está também disponível para consulta na Docbweb do site ICAD, em www.icad.pt .
- O fenómeno da língua vilosa nigraPublication . Limbert, M; Amaral, F; Maio, P; Rebelo, D
- Giant Cell Arteritis With Central Nervous System Vasculitis Presenting As Binocular Diplopia and Ptosis due to Third Cranial Nerve PalsyPublication . Casanova Pinto, J; Costa, MG; Fernandes, B; Ramalheira, CWe report the case of a woman in her 60s with no notable comorbidities presented with a four-week history of bilateral temporal headache, scalp tenderness, jaw claudication, and sporadic fever. She also reported binocular diplopia for the previous 24 hours. Examination revealed tender superficial temporal arteries (TA) and right-sided third cranial nerve palsy with ptosis. Laboratory tests showed elevated inflammation markers. Cranial and cervical computed tomography (CT) and CT angiography (CTA) were unremarkable. She was treated with a single dose of intravenous methylprednisolone, followed by oral prednisolone. Subsequent TA duplex ultrasound demonstrated artery wall thickness, and TA biopsy confirmed chronic inflammation with disruption of the internal elastic lamina, both consistent with giant cell arteritis. Cranial magnetic resonance imaging (MRI) revealed scattered punctate areas on T2-weighted fluid-attenuated inversion recovery (FLAIR) sequences, consistent with small-vessel vasculitis. Under corticosteroid treatment, the patient achieved full clinical remission at the four-month follow-up. This case illustrates an uncommon neurological presentation of giant cell arteritis with oculomotor nerve involvement, associated with findings suggestive of central nervous system vasculitis, and highlights the importance of early recognition and prompt corticosteroid treatment to prevent irreversible complications.
- Information Technology in Nursing Practice: A Scoping Review of Assessment Tools for Evaluating Nurses' CompetenciesPublication . Cachata, D; Costa, M; Magalhães, T; Lucas, P; Gaspar, FIntroduction: The ongoing evolution of Health Information Technology has provided professionals with major challenges in maintaining the safety and quality of care provided to patients, especially when it comes to hyper-technological environments in hospital. This has driven the need to develop specific competencies and maintain a balance between ethical aspects, social and legal challenges related to privacy and data security, as well as the challenge of ensuring person-centered care practice. Then it will be important to understand what competences nurses are developing, based on what models and what instruments exist to assess them. Purpose: Identify and map information technologies and measurement instruments used to assess nurses' competencies in technological environments in hospital. Methods: A scoping review was carried out using the methodology presented by The Joanna Briggs Institute. Results: Of the 101 articles extracted, 4 articles were selected where 5 instruments were identified that evaluate: (1) Informatics Competency in Nursing Leaders; (2) Technological Competence as Nursing Care - Perception and Practice dimension; (3) Self-Assessment of Nursing Informatics Skills; (4) Clinical Decision Making in Nursing, and (5) Self-Assessment Questionnaire that Assesses Nurses' Informatics Skills, for nursing informatics. Conclusion: The development and enhancement of technological skills in nursing care provide an innovative and crucial perspective for managing and organizing healthcare delivery. This perspective is of great importance, reinforced by the reality in which nurses find themselves, with highly technological nursing practice environments that are increasingly developed. Knowledge and use of IT equipment, areas of basic IT knowledge, information literacy, wireless device skills, the role of clinical IT, and applied IT skills are some of the skills identified by this study. The use of various support tools as instruments for clinical decision-making in nursing is also fundamental to the quality of nursing care.