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Saúde - CUF - Tejo

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  • Air quality self-management in asthmatic patients with COPD: An integrative review for developing nursing interventions to prevent exacerbations
    Publication . Sebastião, BF; Hortelão, RM; Granadas, SS; Faria, JM; Pinto, JR; Henriques, HR
    Objectives: Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) patients experience a lower quality of life, frequent exacerbations, and worse pulmonary function. Environmental management is essential in a complex chronic condition, as pollutant exposure can worsen symptoms and increase morbidity and mortality. We aimed to identify evidence that informs nursing interventions in promoting self-management of air quality in asthmatic people with COPD. Methods: We conducted an integrative review in March of 2023. We searched the databases CINAHL, MEDLINE, Academic Search Complete, Cochrane Database of Systematic Reviews (CDSR), Scopus, Web of Science, Joanna Briggs Institute (JBI) Evidence-Based Practice Database, and Google Scholar. We included articles whose participants were adults with asthma, COPD, or both; the intervention was air quality management and the outcome of any exacerbations. We excluded editorials, letters, commentaries, opinion papers, position papers, study protocols, conference abstracts, and reviews. Data extraction and synthesis were performed, categorizing interventions according to nursing actions. Methodological quality assessment was conducted using the JBI Critical Appraisal Checklist tools. The review protocol was registered at Open Science Framework (https://doi.org/10.17605/OSF.IO/5Y4KW). Results: We included five articles from different countries. The interventions promoting air quality self-management for individuals with asthma and COPD included vigilance interventions (health professional regular visits, assessment of symptoms), monitoring interventions (measurement of indoor and outdoor trigger factors), and educational interventions (air quality alerts, allergen avoidance). Policy interventions such as smoke-free policies and comprehensive strategies to improve air quality were also identified. These areas of focus represent critical components of nurses' interventions and can integrate the fundamental patterns of knowing in nursing. Although the studies reveal heterogeneous interventions and the methodological quality is variable, these interventions showed potential for preventing exacerbations, reducing emergency department visits, and minimizing hospitalizations. Conclusions: The study emphasizes the need for a comprehensive approach involving nurses in multidisciplinary teams to air quality self-management. They can use these results to inform their interventions and ways of knowing, benefiting individuals with asthma and COPD. Further research is needed to expand the evidence base and refine these interventions.
    2024Journal article Open access Show more
  • 2021Journal article Open access Show more
  • Assessing the benefits of the “Intergalactic World” social emotional learning program for 8–12-year-old children in Portugal: perspectives from teachers and caregivers
    Publication . Antunes, R; Alexandre, J; Guedes, M; Filipe, MG; Veríssimo, M
    Introduction: "Intergalactic World" is a new social-emotional program designed to reduce psychopathological symptoms and improve social and emotional skills in children aged 8-12. This study aims to evaluate the program's benefits from teachers' and caregivers' perspectives, focusing on internalizing and externalizing behaviors. Methods: The findings were obtained through self-reported measures using a pretest-posttest design with a follow-up period, but with no control group. One hundred fifty-four children (M age = 9.66, SD = 0.78) participated in this intervention study. Eleven teachers completed the Teacher's Report Form (TRF) for these children, and 133 caregivers completed the Child Behavior Checklist (CBCL). Participants without caregivers' reports were excluded from the analysis. Data were collected at three-time points: before the intervention (T1), immediately after (T2), and 6 months after the implementation of the program (T3). Results: Results (n = 133) showed an effect of time on the Internalization scores (at T3 for teachers and T2 and T3 for caregivers) with no gender effect and a decrease in the perception of externalizing behaviors with a gender effect: Boys were perceived as exhibiting more externalizing behaviors than girls. However, these behaviors significantly decrease at T3 for teachers and at T2 and T3 for caregivers. Discussion: Despite its limitations, this study highlights the benefits of employing social-emotional programs to help reduce children's internalizing and externalizing behaviors. A multi-informant approach enables a comprehensive analysis and provides insights into the child's significant contexts and interactions with adults.
    2023Journal article Open access Show more
  • 2022Journal article Open access Show more
  • Can the free/total psa ratio predict undetected intraductal carcinoma and cribriform pattern at biopsy?
    Publication . Bernardino, RM; Yin, LB; Lajkosz, K; Cockburn, JG; Wettstein, MS; Woon, D; Nguyen, DD; Sayyid, R; Leão, R; van der Kwast, T; Fleshner, N
    Background: Intraductal carcinoma (IDC) and cribriform pattern (Crib) of prostate cancer are recognised as independent prognosticators of poor outcome, both in prostate biopsies and radical prostatectomy (RP) specimens. Objective: This study aimed to determine the predictive value of Free-to-total PSA ratio (FPSAR) in identifying missed IDC/Crib at the time of biopsy as compared to the final surgical specimen. Materials and methods: Patients who underwent RP between January 2015 and December 2022 were included in the study. Predictors of a false negative biopsy were examined using a multivariate logistic regression. Associations between true positive/true negative/false negative biopsies (for IDC/Crib) with FPSAR as primary outcome parameter were determined using Chi-squared test and Kruskal-Wallis test. Results: This study included 639 patients who underwent radical prostatectomy between 2015 and 2022 (Table 1) and had available FPSAR- at the time of biopsy. The median age was 63.0 years (IQR: 58.9-68.0). The median serum PSA before RP was 7.0 ng/ml (IQR: 5.3-9.5). Among the 639 patients, 177 (28%) had Crib, and 97 (15%) had IDC on prostate biopsy, with 54 (9%) patients having both IDC and Crib. Concerning Grade Group distribution at biopsy, there was: GG1 in 62 patients (10%), GG2 in 428 (67%), GG3 in 102 (16%), GG4 in 28 (4%), and GG5 in 19 (3%) patients. On multivariate regression analysis, the following were associated with lower odds of a false-negative IDC/Crib biopsy: Percentage of pattern 4 ≥ 10% at biopsy (odds ratio [OR] 0.17, 95% CI 0.10-0.29; p < 0.001); higher Gleason score (grade group 4/5) on biopsy (OR 0.38, 95% CI 0.16-0.91; p = 0.03) and higher percent of positive cores at biopsy ≥ 33% (OR 0.51, 95% CI 0.29-0.88; p = 0.02). FPSAR ≥ 0.10 was not an independent predictor of a false-negative IDC/Crib biopsy (p > 0.05). Conclusions: In conclusion, our study's findings suggest that FPSAR is not a reliable biomarker for identifying IDC/Crib status at the time of biopsy. Further research is needed to identify biomarkers or combinations of biomarkers that can improve the diagnostic accuracy for these aggressive variants of PCa. Our study that involved 639 patients shows that FPSAR is not a good marker for detecting aggressive types of PCa, during a biopsy. More research is needed to find better markers or combinations of markers that can help diagnose these aggressive forms of prostate cancer more accurately.
    2024Journal article Open access Show more
  • Candy cane syndrome: A systematic review
    Publication . Rio-Tinto, R; Canena, J; Devière, J
    Background: Candy cane syndrome (CCS) is a condition that occurs following gastrectomy or gastric bypass. CCS remains underrecognized, yet its prevalence is likely to rise due to the obesity epidemic and increased use of bariatric surgery. No previous literature review on this subject has been published. Aim: To collate the current knowledge on CCS. Methods: A literature search was conducted with PubMed and Google Scholar for studies from May 2007, until March 2023. The bibliographies of the retrieved articles were manually searched for additional relevant articles. Results: Twenty-one articles were identified (135 patients). Abdominal pain, nausea/vomiting, and reflux were the most reported symptoms. Upper gastrointestinal (GI) series and endoscopy were performed for diagnosis. Surgical resection of the blind limb was performed in 13 studies with resolution of symptoms in 73%-100%. In surgical series, 9 complications were reported with no mortality. One study reported the surgical construction of a jejunal pouch with clinical success. Six studies described endoscopic approaches with 100% clinical success and no complications. In one case report, endoscopic dilation did not improve the patient's symptoms. Conclusion: CCS remains underrecognized due to lack of knowledge about this condition. The growth of the obesity epidemic worldwide and the increase in bariatric surgery are likely to increase its prevalence. CCS can be prevented if an elongated blind loop is avoided or if a jejunal pouch is constructed after total gastrectomy. Diagnosis should be based on symptoms, endoscopy, and upper GI series. Blind loop resection is curative but complex and associated with significant complications. Endoscopic management using different approaches to divert flow is effective and should be further explored.
    2023Journal article Open access Show more
  • Central airway obstruction: is it time to move forward?
    Publication . Guedes, F; Branquinho, MV; Sousa, AC; Alvites, RD; Bugalho, A; Maurício, AC
    Introduction Central airway obstruction (CAO) represents a pathological condition that can lead to airflow limitation of the trachea, main stem bronchi, bronchus intermedius or lobar bronchus. Main body It is a common clinical situation consensually considered under-diagnosed. Management of patients with CAO can be difficult and deciding on the best treatment approach represents a medical challenge. This work intends to review CAO classifications, causes, treatments and its therapeutic limitations, approaching benign and malign presentations. Three illustrative cases are further presented, supporting the clinical problem under review. Conclusion Management of CAO still remains a challenge. The available options are not always effective nor free from complications. A new generation of costume-tailored airway stents, associated with stem cell-based therapy, could be an option in specific clinical situations.
    2022Journal article Open access Show more
  • CIRSE Standards of Practice on Conducting Meetings on Morbidity and Mortality
    Publication . Chun, JY; Bharadwaz, A; Kyaw Tun, J; Bilhim, T; Gonzalez-Junyent, C; Kawa, B
    This CIRSE Standards of Practice document is developed by an expert writing group under the guidance of the CIRSE Standards of Practice Committee. It aims to assist Interventional Radiologists in their daily practice by providing best practices for conducting meetings on morbidity and mortality.
    2021-05-14Journal article Open access Show more
  • 2024Journal article Open access Show more
  • Clinical Outcomes and Patient Satisfaction of an Enhanced Depth of Focus Intraocular Lens Targeted for Mini-Monovision
    Publication . Campos, N
    Purpose: To assess the clinical outcomes, the rate of spectacle independence, and patient satisfaction of an enhanced depth of focus (EDOF) LuxSmart™ IOL targeted for mini-monovision in patients who had undergone bilateral cataract surgery. Methods: Twenty patients underwent bilateral LuxSmart IOL implantation with the non-dominant eye targeted for -0.50 diopters. Best-corrected distance (CDVA) and uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA) at 66 cm, uncorrected near visual acuity (UNVA) at 40 cm, and defocus curve were assessed. Patient-reported visual function was inquired by Catquest-9SF, and the rate of spectacle independence in all daily-life activities was calculated. The presence of photic phenomena was evaluated. A p-value lower than 0.05 was considered statistically significant. Results: The mean IOL power was +21.50 ± 4D (16.5-26D), and all were non-toric. Thirty-seven (92.5%) eyes were within ±0.5D of predicted target. The postoperative MRSE was 0.06 ± 0.42D and -0.45 ± 0.22D in dominant and non-dominant eyes. Every patient achieved distance binocular vision better than 0.1 logMAR. The non-dominant eyes showed lower CDVA (p<0.001). The UIVA was higher in non-dominant eyes (p<0.001). Binocular uncorrected near visual acuity was 0.12 ± 0.1, and uncorrected near visual acuity was higher in non-dominant eyes (p<0.001). LuxSmart IOL provided a sustained visual acuity of 0.3 logMAR or better between +1.00D and -2.50D. A total of 25% of patients reported frequent halos and glare. Despite achieving higher degrees of satisfaction, seven patients (35%) denied total spectacle independence in their daily-life activities, particularly for activities requiring continuous near vision. Conclusion: This study shows that LuxSmart EDOF IOL in mini-monovision strategy performs well for distance and intermediate vision. Although visual acuity for near also achieved very good results, the considerable rate of spectacle dependence, in particular for near, and the rate of photic phenomena do not support this IOL to be safely implanted in patients desiring spectacle independence at time of cataract surgery
    2024Journal article Open access Show more