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- Orthostatic hypotension and cardiovascular events: closing the link?Publication . Pereira, Telmo
- Impacto do EEG Ambulatório de 24 Horas na abordagem clínica a doentes com suspeita de EpilepsiaPublication . Batista, Carla; Borges, Daniel Filipe; Coelho, Paulo; Ferreira, Axel; Pereira, Telmo; Conde, JorgeIntrodução: O eletroencefalograma constitui a técnica gold-standard para avaliar a atividade cortical epileptógenea. No entanto, a sua sensibilidade revela-se baixa nas modalidades de registo de curta duração, sendo que, neste contexto, a utilização do EEG Ambulatório de 24 horas (EEGa) veio permitir uma maior capacidade diagnóstica, enquanto registo prolongado, a custos controlados. Objetivo: Analisar o impacto do EEGa na avaliação de doentes com suspeita de epilepsia, através da sua sensibilidade e especificidade para esse diagnóstico clínico. Secundariamente, a) avaliar a sensibilidade em função da distância temporal à última crise, b) averiguar se existe relação entre a presença de atividade paroxística e lesão, c) avaliar o follow-up dos doentes e d) determinar possíveis fatores preditivos. Material e Métodos: Estudo observacional retrospetivo de uma amostra contínua dos pacientes com suspeita de epilepsia que realizaram EEGa entre maio de 2011 e maio de 2018 no Laboratório de Neurofisiologia da Unidade Local de Saúde de Matosinhos. Resultados: Amostra de 83 indivíduos, com idade média de 44.5 anos (79 adultos e 4 pediátricos). A sensibilidade foi de 97% e especificidade de 73% para o diagnóstico de epilepsia, com uma taxa de falsos positivos e falsos negativos de 5% e 7%, respetivamente. Conclusões: O EEGa deve ser um estudo neurofisiológico a considerar mais frequentemente na prática clínica, almejando um diagnóstico mais precoce de epilepsia ou contrariando este, designadamente nos casos em que os exames de primeira linha sejam normais e a convicção clínica permaneça. A brevidade obtida para o diagnóstico evita as expectáveis e demais consequências.
- Clinical usefulness of the electroencephalogram in acute stroke: a preliminary studyPublication . Borges, Daniel Filipe; Silva, Mariana; Ferreira, Axel; Coelho, Paulo Simões; Pereira, Telmo; Conde, JorgeIntroduction: Stroke is the main cause of disability worldwide, being the first cause of death in Portugal. In the first hours of the event, the cranioencephalic CT scan (CT Scan) does not show the lesion in about 74% of cases, making validation of alternative diagnostic approaches of utmost importance. The electroencephalogram (EEG) may provide useful information for the diagnosis and prognosis of stroke. Objective: To study the potential usefulness of the EEG for the early diagnosis of acute stroke in patients with initial negative CT Scan, and for the evaluation of the functional status and risk of epilepsy. Methods: Retrospective analysis of patients with ischemic stroke who underwent EEG and acute phase CT scan between January 2014 and February 2018. Patient characteristics and stroke were classified according to the Oxfordshire Community Stroke Project (OCSP) criteria. The patients were functionally evaluated at 12 months post-stroke by the modified Rankin Scale (mRS) and the existence of post-stroke epilepsy was determined by telephone interview on February 2018. Results: Thirty patients (25 females and 5 males, mean age 70.5 years) were included. According to the OCSP were identified: 40% TACS, 37% PACS, 10% LACS and 13% POCS. 50% with acute vascular injury visible on the initial CT Scan performed with 7 hours of evolution in median. All patients underwent EEG with a median of 3 days of evolution, and slow focal activity was observed in all patients, and focal paroxysmal activity (PA) was seen in 17% of the participants. 17 patients (58% of patients) developed post-stroke epilepsy (PSE) with 4 of these having PA evidence in the initial EEG (24%). One of the patients with PA in the initial EEG did not develop epilepsy during a 4 years follow-up period. In patients without PA, the average of mRs at follow-up was 3.8 and the mortality was 24%, whereas in patients with PA, the mean of the mRs was 5.0 and the mortality was 40%. Conclusion: In this study, unlike CT Scan, the acute-phase EEG presented with abnormal features in all patients with acute stroke, therefore the EEG may potentially provide significant diagnostic information, estimates of risk for developing future epilepsy and also overall risk stratification. Further studies are needed to validate this hypothesis.
- Randomized study of the effect of cocoa, on the blood pressure of healthy young individualsPublication . Coutinho, D; Pereira, J; Pereira, TelmoIntroduction: Since ancient times, chocolate is a food highly appreciated by people and, therefore, is present in varied eating patterns. When rich in cocoa, it has a higher concentration of flavonoids. The consumption of foods rich in flavanols has been associated with a reduction in some risk factors for cardiovascular diseases, such as hypertension. Objectives: To evaluate the effects of frequent consumption of a fixed dose of cocoa-rich chocolate on the blood pressure of healthy young individuals. Methods: Thirty healthy individuals of both sexes, aged between 18 and 35 years, were randomized, but only 28 people completed the intervention. A baseline blood pressure assessment was performed. After this the different types of chocolate were distributed by the control group (55% cocoa) and the intervention group (90% cocoa). The daily consumption of 20 grams of chocolate ran for thirty days. Two days after finishing the ingestion of the chocolate, the second evaluation was carried out. For the different evaluations, the oscillometric method was used. Results: In the different variables studied, there was a general improvement in both groups (control and intervention). However, there were only statistically significant differences in systolic blood pressure (p = 0.01) and pulse pressure (p = 0.001), in the control group. In the baseline assessment, it was found that there were no statistically significant differences between the two groups. Conclusions: This study showed that chocolate, with 55% cocoa, has beneficial effects on the blood pressure of healthy young individuals, when consumed frequently. Further research is needed with regard to the mechanisms associated with these effects, so that we can clarify the role of flavonoids.
- Autonomic function recovery and physical activity levels in post-COVID-19 young adults after immunization: an observational follow-up case-control studyPublication . Freire, Ana Paula Coelho Figueira; Amin, Shaan; Lira, Fabio Santos; Morano, Ana Elisa von Ah; Pereira, Telmo; Coelho-E-Silva, Manuel-João; Caseiro, Armando; Christofaro, Diego Giulliano Destro; Santos, Vanessa Ribeiro dos; Júnior, Osmar Marchioto; Pinho, Ricardo Aurino; Silva, Bruna Spolador de AlencarCoronavirus disease 2019 (COVID-19) has detrimental multi-system consequences. Symptoms may appear during the acute phase of infection, but the literature on long-term recovery of young adults after mild to moderate infection is lacking. Heart rate variability (HRV) allows for the observation of autonomic nervous system (ANS) modulation post-SARS-CoV-2 infection. Since physical activity (PA) can help improve ANS modulation, investigating factors that can influence HRV outcomes after COVID-19 is essential to advancements in care and intervention strategies. Clinicians may use this research to aid in the development of non-medication interventions. At baseline, 18 control (CT) and 20 post-COVID-19 (PCOV) participants were observed where general anamnesis was performed, followed by HRV and PA assessment. Thus, 10 CT and 7 PCOV subjects returned for follow-up (FU) evaluation 6 weeks after complete immunization (two doses) and assessments were repeated. Over the follow-up period, a decrease in sympathetic (SNS) activity (mean heart rate: p = 0.0024, CI = −24.67–−3.26; SNS index: p = 0.0068, CI = −2.50–−0.32) and increase in parasympathetic (PNS) activity (mean RR:p = 0.0097, CI = 33.72–225.51; PNS index: p = 0.0091, CI = −0.20–1.47) were observed. At follow-up, HRV was not different between groups (p > 0.05). Additionally, no differences were observed in PA between moments and groups. This study provides evidence of ANS recovery after SARS-CoV-2 insult in young adults over a follow-up period, independent of changes in PA.
- Effects of a personalized intervention program on the biochemical and hematological profile in community dwelling old adults-the AGA@4life intervention modelPublication . Caseiro, Armando; Rocha, Clara; Silva, Ana Margarida; Ferreira, Carla; Silva, Isabel; Clemente, Mariana; Cipriano, Inês; Saraiva, Marina; Barreira, Rogério; Azenha, Joana; Loureiro, Maria Helena; Martins, Anabela; Pereira, TelmoAging is a social and economic challenge of the highest importance and a multidisciplinary intervention seems to be a promising approach for improving the quality of life of elderly individuals. This project was designed aimed at promoting an active and healthy aging through the implementation of an intervention program based on the comprehensive geriatric assessment model (AGA@4life), focused on promoting health and wellbeing, independence and autonomy, mobility, and social inclusion. A non-randomized interventional study was designed to evaluate the effect of only a dietetic and nutritional approach (control group (CG)) and the combination of a tailored exercise program and a dietetic and nutritional approach (intervention group (IG)) in the biochemical and hematological profile of older adults in the framework of AGA@4life. The 34 participants enrolled, aged 65 years or over, were subject to a thorough baseline (T0) multidisciplinary diagnostic evaluation, including the gathering of clinical information and a battery of biochemical and hematological determinations, and reevaluated after eight weeks of intervention (T1). Between T0 and T1, an increase in albumin and total proteins serum levels were observed in both groups (p < 0.01); the hematological profile in CG and IG showed an increase in red cell count and hemoglobin (p < 0.05). In IG, an increase of HDL cholesterol (p < 0.001) and a decrease of triglycerides (p = 0.001) were still observed. The AGA@4life multidisciplinary intervention improved the hematological and biochemical profile of old adults, potentially contributing to delay the development of several aging comorbidities and increase the quality of life of participants.
- Laboratory Assessment of the Effects of AGA@4life Multidisciplinary Intervention on the Inflammatory Profile, MMPs, and TIMPs in a Geriatric PopulationPublication . Lourenço, Ana Patrícia; Freitas, Catarina; Timóteo, Maria Helena; Soares, Maria; Figueiredo, João; Osório, Nádia; Valado, Ana; Trapali, Maria; Pereira, Telmo; Caseiro, ArmandoAbstract: In recent years, the world’s aging population has increased, contributing to the development of age-related pathologies, which have been aggravated by physical inactivity and excessive fat intake. This study aimed to evaluate the effect of implementing a nutritional program (control group—CG) combined with exercise (intervention group—IG) on the inflammatory profile, MMPs, and TIMPs in a group of 34 elderly participants (IG, n = 18; CG, n = 16). Participants underwent a full multidisciplinary diagnostic evaluation (T0), with the gathering of clinical information and biochemical and hematological determinations being re-evaluated eight weeks later (T1). A diet manual was made, which provided a selection of different types of diets resulting from the nutritional needs of the different users at the center. The aerobic exercise consisted of two sessions per week with a total duration of 1 h. The laboratory evaluation was performed by slot blot. Statistical analysis included a paired sample t-test and Spearman’s correlation coefficient. We observed that in the IG, there was a significant increase at T1 of TNF-α (p < 0.05) and MMP-2 (p < 0.05), without changes in IL-6 and MMP-9, showing that the intervention did not cause an exacerbated inflammatory response in exercised elderly people. The intervention program implemented showed potential to contribute to better active aging strategies, taking advantage of the known benefits of exercise without inducing a harmful inflammatory response in elderly participants.
- Respiratory function and muscular capacity in old adults: the AGA@4life projectPublication . Pedroso, Daniel Alexandre Dias; Pereira, Telmo; Conde, Jorge
- Randomized pilot study on the effects of sarcocornia as a salt substitute in arterial blood pressure and vascular function in healthy young adultsPublication . Pereira, Telmo; Caldeira, Andreia Torres; Caseiro, Armando; Osório, Nádia; MOREIRA DA SILVA, AIDA; Barroca, MJPrevious studies have shown that excessive salt intake is strongly associated with high blood pressure (HT), vascular dysfunction, and the overall risk of cardiovascular diseases. The aim of this study was to evaluate Sarcocornia effectiveness as a salt substitute, addressing its effect on cardiovascular function in healthy young individuals. Thirty healthy participants, aged 18 to 26 years, were randomized into two groups: the control group (CG) and the intervention group (IG). The IG used Sarcocornia powder as a salt substitute for cooking, and the CG used regular salt, during a period of 1 month. A baseline evaluation was performed before the participants started the intervention phase, and was repeated after a 30-day intervention period. Each evaluation included blood pressure (BP) measurement, carotid-femoral pulse wave velocity (PWV), and carotid pulse wave analysis (PWA), and blood samples were also collected for analysis. Sodium excretion was measured at baseline and after intervention through spot urine collection and analysis, a method suitable for this population but with known limitations. Baseline parameters were similar between groups and were within the normal range. Sodium excretion remained unchanged in the two evaluations in the CG, but significantly decreased after intervention in the IG. The reduction in sodium excretion in the IG was followed by a significant reduction in brachial and aortic systolic (SBP) and diastolic blood pressure (DBP), and also in PWV. No significant changes were observed in the CG in terms of cardiovascular parameters. This preliminary study conveys positive results in favor of Sarcocornia as a dietary substitute for regular salt, providing added evidence of the negative cardiovascular effects of high salt intake in young and healthy adults.
- Avaliação laboratorial do efeito antioxidante e anti-inflamatório do Resveratrol na função vascularPublication . Silva, Ana Margarida; Ferreira, Carla; Dias, Beatriz; Silva, Isabel; Clemente, Mariana; Figueiredo, João; Pereira, Telmo; Caseiro, ArmandoIntrodução: O resveratrol é uma fitoalexina natural cujos principais benefícios devem-se às suas propriedades anti-inflamatórias e antioxidantes. Os seus efeitos sugerem que este é um suplemento útil para a redução da inflamação, podendo desempenhar um papel fundamental na prevenção das doenças cardiovasculares. Este promove a vasodilatação pela indução da síntese de óxido nítrico (NO), possui atividade antitrombótica e evita a agregação plaquetária. O fator de crescimento endotelial vascular ( VEGF) é responsável pela angiogénese, sendo a sua expressão infuenciada pelo resveratrol. Objetivos: Avaliar o efeito do resveratrol no perfl vascular pela determinação da pressão arterial e dos biomarcadores interleucina-6 (IL-6), proteína C reativa (PCR), VEGF e NO. Material e Métodos: 27 alunos com idades compreendidas entre os 18 e os 22 anos foram divididos em grupo controlo (GC) e grupo de intervenção (GI), que consumiram placebo e 100 mg de resveratrol por dia, respetivamente, durante 1 mês. A pressão arterial foi medida com aparelho automático validado. Os níveis de PCR foram obtidos por imunoturbidimetria, os de IL-6 e VEGF por slot blot e a quantifcação de NO por espectrofotometria. Resultados: Entre os grupos observou-se uma diminuição da pressão arterial braquial e central (ρ˂0.05). A variação negativa no NO apresentou-se superior no GC apesar das diferenças não serem signifcativas (p>0,05). Nos restantes marcadores avaliados não se observaram diferenças signifcativas. Conclusões: A ingestão regular de resveratrol parece ser uma abordagem preventiva a nível vascular, dado que modula positivamente o perfl vascular, reduzindo a pressão arterial. A variação nos níveis de NO poderá ajudar a explicar os benefícios verifcados.
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