LS - Lusíadas Saúde
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A Lusíadas Saúde (fundada em 1998) é um grupo de referência no setor da saúde em Portugal cuja missão é ajudar as pessoas a viver vidas mais saudáveis e contribuir para que o sistema de saúde funcione melhor para todos.
Bem-vindo ao Repositório da Lusíadas Saúde.
O Repositório Lusíadas Saúde pretende recolher, armazenar, gerir, preservar e dar acesso à produção intelectual da comunidade Lusíadas Contribuindo deste modo para a preservação do output científico da comunidade Lusíadas e aumentando a visibilidade, prestígio e impacto Institucional.
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- Acceptance of Open Preperitoneal Repair in Inguinal Hernia Surgery Delphi-Consensus After an Anonymous International Survey Among European Hernia Society MembersPublication . Lorenz, R; Akkersdijk, W; Paiva De Oliveira, G; Warren, T; Soler, MIntroduction: For years, the Lichtenstein technique was the gold standard for open repair, but several open pre-peritoneal techniques have developed since the fifties of the 20th century that offer some benefits over the Lichtenstein technique in terms of post-surgical incidence of pain. Since the 2023 update of the International HerniaSurge Guidelines, open preperitoneal mesh techniques have been an acceptable alternative, providing available expertise and competence with at least equal results as Lichtenstein repair. Aim: The aim of this project is to understand the views of surgeons regarding the approach to inguinal hernia repair and determine best practice principles for optimal surgical outcomes. Methods: Using a modified Delphi method, a panel of experts developed 43 Likert scale statements across six key domains. These statements were used to develop an online survey distributed to surgeons in Europe involved in inguinal hernia repair. The threshold for consensus was set a priori at 75%. Results: A total of 202 responses were received from surgeons involved in inguinal hernia repair over three rounds of survey. After the initial survey round, seven statements were revised and reissued for a further round. At the conclusion of the survey phase, 31 of the 38 remaining statements achieved consensus (of which 13 achieved ≥90% agreement). From these results, the panellists developed a set of 3 recommendations to help define principles for optimal approach to inguinal hernia repair. Accordingly Open preperitoneal techniques seems to be an alternative to Lichtenstein technique if expertise is available and should be included in a tailored concept. Knowledge of anatomy, Education and Training in open preperitoneal techniques is crucial for the acceptance of these techniques. Conclusion: The proposed set of recommendations provides some principles for surgeons to consider when selecting an approach to inguinal hernia repair, ensuring good patient outcomes in a practical and cost-effective manner.
- Acceptance of Open Preperitoneal Repair in Inguinal Hernia Surgery Delphi-Consensus After an Anonymous International Survey Among European Hernia Society MembersPublication . Lorenz, R; Akkersdijk, W; Paiva De Oliveira, G; Warren, T; Soler, MIntroduction: For years, the Lichtenstein technique was the gold standard for open repair, but several open pre-peritoneal techniques have developed since the fifties of the 20th century that offer some benefits over the Lichtenstein technique in terms of post-surgical incidence of pain. Since the 2023 update of the International HerniaSurge Guidelines, open preperitoneal mesh techniques have been an acceptable alternative, providing available expertise and competence with at least equal results as Lichtenstein repair. Aim: The aim of this project is to understand the views of surgeons regarding the approach to inguinal hernia repair and determine best practice principles for optimal surgical outcomes. Methods: Using a modified Delphi method, a panel of experts developed 43 Likert scale statements across six key domains. These statements were used to develop an online survey distributed to surgeons in Europe involved in inguinal hernia repair. The threshold for consensus was set a priori at 75%. Results: A total of 202 responses were received from surgeons involved in inguinal hernia repair over three rounds of survey. After the initial survey round, seven statements were revised and reissued for a further round. At the conclusion of the survey phase, 31 of the 38 remaining statements achieved consensus (of which 13 achieved ≥90% agreement). From these results, the panellists developed a set of 3 recommendations to help define principles for optimal approach to inguinal hernia repair. Accordingly Open preperitoneal techniques seems to be an alternative to Lichtenstein technique if expertise is available and should be included in a tailored concept. Knowledge of anatomy, Education and Training in open preperitoneal techniques is crucial for the acceptance of these techniques. Conclusion: The proposed set of recommendations provides some principles for surgeons to consider when selecting an approach to inguinal hernia repair, ensuring good patient outcomes in a practical and cost-effective manner.
- Acute Osteomyelitis with Subperiosteal AbscessPublication . Alves, AS; Sousa, S
- Adipose-Derived Stem Cell Therapy Combined With Platelet-Rich Plasma for the Treatment of Avascular Necrosis of the TalusPublication . Sousa, R; Babulal, J; Amado, PAvascular necrosis (AVN) is characterized by compromised blood supply to bone tissue, often resulting in significant pain and functional impairment. Conservative treatment options for early-stage AVN of the talus are scarce, with non-weight-bearing protocols and hyperbaric oxygen therapy showing limited efficacy. This report presents a potential novel approach to managing non-traumatic AVN of the talus using a combination of adipose-derived stromal vascular fraction (SVF) and platelet-rich plasma (PRP). A 60-year-old male presented with progressive right ankle pain of a two-year evolution. Magnetic resonance imaging (MRI) revealed stage II AVN of the talus with extensive bone infarctions occupying almost all of its volume but with no collapse. A single injection of SVF and PRP was performed after diagnostic arthroscopy, followed by a tailored rehabilitation protocol. The patient experienced significant pain relief, with no further need for analgesics, and was able to return to non-impact sports. At the 18-month follow-up, functional scores showed significant improvement, and MRI showed stable AVN with no evidence of collapse. This report highlights SVF and PRP as a potential effective conservative option for non-traumatic talar AVN.
- Adjustable Gastric Banding Conversion to One Anastomosis Gastric Bypass: Data Analysis of a Multicenter DatabasePublication . Pujol-Rafols, J; Uyanik, O; Curbelo-Peña, Y; Abbas, AA; Devriendt, S; Guerra, A; Herrera, MF; Himpens, J; Pardina, E; Pouwels, S; Ramos, A; Ribeiro, RJ; Safadi, B; Sanchez-Aguilar, H; De Vries, CE; Van Wagensveld, BIntroduction: One anastomosis gastric bypass (OAGB) has been proposed as a rescue technique for laparoscopic adjustable gastric banding (LAGB) poor responders. Aim: We sought to analyze, complications, mortality, and medium-term weight loss results after LAGB conversion to OAGB. Methods: Data analysis of an international multicenter database. Results: One hundred eighty-nine LAGB-to-OAGB operations were retrospectively analyzed. Eighty-seven (46.0%) were converted in one stage. Patients operated on in two stages had a higher preoperative body mass index (BMI) (37.9 vs. 41.3 kg/m2, p = 0.0007) and were more likely to have encountered technical complications, such as slippage or erosions (36% vs. 78%, p < 0.0001). Postoperative complications occurred in 4.8% of the patients (4.6% and 4.9% in the one-stage and the two-stage group, respectively). Leak rate, bleeding episodes, and mortality were 2.6%, 0.5%, and 0.5%, respectively. The final BMI was 30.2 at a mean follow-up of 31.4 months. Follow-up at 1, 3, and 5 years was 100%, 88%, and 70%, respectively. Conclusion: Conversion from LAGB to OAGB is safe and effective. The one-stage approach appears to be the preferred option in non-complicate cases, while the two-step approach is mostly done for more complicated cases.
- Advancing patient‐centered care: Recent developments in UEG's patient relationsPublication . Burra, P; Amil Dias, J; Torres, J; Botos, A; Acedo, P; Bertelsen, B; Bretthauer, M; Carboni, A; Dugic, A; Fracasso, P; Koltai, T; Leone, S; Maravic, Z; Matysiak‐Budnik, T; McColaugh, L; Mishkovikj, M; Wickramasinghe, K; van Leerdam, M
- Advancing Towards a Targeted Surveillance Strategy in Traumatic Brain InjuryPublication . Moura Gonçalves, V
- Um Afrodisíaco Potencialmente Fatal: Intoxicação por CantaridinaPublication . Diaz, P; Carneiro, A; Montes, V; Alves, SCantharidin is a toxin extracted from coleoptera beetles, commonly known as 'Spanish fly'. Traditionally it was used as an aphrodisiac, a vesicant or as an abortifacient. Intoxication by this substance has been widely reported, generally associated with gastrointestinal complications, such as digestive hemorrhage, and genitourinary disorders, such as hematuria and acute kidney injury. The authors describe the case of a 51-year old male patient who developed severe cantharidin poisoning after ingesting a preparation ('tea formulation') containing the substance. The patient reported a burning sensation in his oral cavity, diarrhea and hematuria, having sustained acute kidney injury and atypical neurological symptoms. Due to the lack of an antidote, the available treatment options are reduced to supportive measures. This case strengthens the need for a thorough medical history to ascertain the use of 'natural' products and medicinal herbs (i.e. of unregulated origin), and the importance of educating the community to their potential toxicity.
- Analysis of Genes Involved in Oxidative Stress and Iron Metabolism in Heart Failure: A Step Forward in Risk StratificationPublication . Silva, PX; Aguiar, L; Gaspar, M; Faustino, P; Falcão, LM; Barbosa, M; Bicho, M; Inácio, ÂIntroduction: Heart failure (HF) is a clinical syndrome characterized by cardinal symptoms that may be accompanied by signs. It results from structural and/or functional abnormalities of the heart leading to elevated intracardiac pressures and/or inadequate cardiac output at rest and/or during exercise. The prevalence of iron deficiency and anemia justifies the current guidelines recommendation of screening. Genes HP, ACE, MTHFR, HFE, and CYBA are involved in oxidative mechanisms, iron metabolism, and hematologic homeostasis. This study investigates the contribution of variants Hp1/2 (HP), I/D (ACE), C677T (MTHFR), C282Y and H63D (HFE), and C242T (CYBA) to the development of HF, either independently or in epistasis. Methods: We used a database of 389 individuals, 143 HF patients, and 246 healthy controls. Genotypes were characterized through PAGE electrophoresis, PCR, PCR-RFLP, and multiplex-ARMS. Data analysis was performed with the SPSS® 26.0 software (IBM Corp., Armonk, NY). Results: We observed a significant association between the MTHFR gene and HF predisposition. The presence of allele T and genotype CT constituted risk, while genotype CC granted protection. Epistatic interactions revealed risk between genotype II of the ACE gene and genotypes CC (C282Y) or HH (H63D) of the HFE gene. Risk was also observed for interactions between genotype CC (CYBA)and genotypes 2-2 (HP), CT (MTHFR), or HH (HFE-H63D). Conclusion: We concluded that genes HP, ACE, MTHFR, HFE, and CYBA contribute to the susceptibility for HF, individually or in epistasis. This study contributes to the clarification of the role that genes involved in oxidative mechanisms and iron metabolism play in the physiopathology of HF. It is, therefore, a step forward in risk stratification and personalized medicine.
- Association of physical activity with physical function and quality of life in people with hip and knee osteoarthritis: longitudinal analysis of a population-based cohortPublication . Lopes, DG; Costa, D; Cruz, EB; Mendonça, N; Henriques, AR; Branco, J; Canhão, H; Rodrigues, AMHip and knee osteoarthritis (HKOA) is a chronic disease characterized by joint pain that leads to reduced physical function and health-related quality of life (HRQoL). At present, no cure is available. Clinical trials indicate that people with HKOA benefit from physical activity in several health-related outcomes. However, few studies have evaluated the long-term positive effect of regular physical activity. This study analyzed participants with HKOA from a nationwide population-based cohort (EpiDoC Cohort) to assess the impact of physical activity on patients' physical function and HRQoL over a long-term follow-up. The regular weekly frequency of intentional physical activity was self-reported as non-frequent (0 times/week), frequent (1-2 times/week), or very frequent (≥ 3 times/week). This study followed 1086 participants over a mean period of 4.7 ± 3.4 years, during which 6.3% and 14.9% of participants reported frequent and very frequent physical activity, respectively. Using linear mixed models, we found that frequent (β = - 0.101 [- 0.187, - 0.016]; β = 0.039 [- 0.002, 0.080]) and very frequent physical activity (β = - 0.061 [- 0.118, - 0.004]; β = 0.057 [0.029, 0.084]) were associated with improved physical function and HRQoL over time, respectively, when compared with non-frequent exercise, adjusting for years to baseline, sex, age, years of education, body mass index, multimorbidity, hospitalizations, clinical severity, and unmanageable pain levels. These findings raise awareness of the importance of maintaining exercise/physical activity long term to optimize HRQoL and physical function. Further studies must address barriers and facilitators to improve the adoption of regular physical activity among citizens with HKOA.