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Curto A, Ferro S, Santos C, Lourenço M, Fahy GE, Anselmo D, Fernandes T. Comparing morphological ( os coxae) and metric (long bone length) sex estimation methods in archaeological collections. Anthropol Anz 2024; 81:139-151. [PMID: 37580945 DOI: 10.1127/anthranz/2023/1730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 08/16/2023]
Abstract
Objectives: The aim of this study is to evaluate the internal consistency of sex estimation using metric (long bone length) and morphological (os coxae) methodologies from different bones and across different archaeological populations from different regions. Materials and Methods: Sex was estimated using characteristics of the pelvis and compared with sex estimations using long bone length. Portuguese (659 females; 906 males) and English (141 females; 277 males) archaeological collections were analysed in this study. A set of long bone length functions were developed using one of the archaeological collections (531 females; 600 males) and its coincidence with sex estimated from the pelvis was compared to the coincidence between the pelvis and long bone length sex estimations using functions developed from contemporary collections. Intra- and inter-observer errors were calculated, as well as the sexual dimorphism index for each bone and osteological collection. Results: The accuracy of the developed functions and the other methods tested is highly variable, ranging between 25 and 100%. The accuracy of the standard forensic methods varied between collections and analysed bones. Discussion: This study reinforces that long bone length is highly population-specific, even between samples of close chronology and geography. Metric methods are good options to strengthen the sex estimations, but they need to be carefully chosen and always report the estimated probability of being male or female in either forensic or archaeological analysis.
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Affiliation(s)
- Ana Curto
- Laboratório HERCULES, Palácio do Vimioso, Largo Marquês de Marialva, University of Évora, 7000-809 Évora, Portugal
- Department of Biology, Pólo da Mitra, University of Évora, 7002-554 Évora, Portugal
| | - Sónia Ferro
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal University of Coimbra, Centre for Functional Ecology, Laboratory of Forensic Anthropology, Department of Life Sciences, Calçada Martim de Freitas, 3000-456 Coimbra, Portugal
| | - Cláudia Santos
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal University of Coimbra, Centre for Functional Ecology, Laboratory of Forensic Anthropology, Department of Life Sciences, Calçada Martim de Freitas, 3000-456 Coimbra, Portugal
| | - Marina Lourenço
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal University of Coimbra, Centre for Functional Ecology, Laboratory of Forensic Anthropology, Department of Life Sciences, Calçada Martim de Freitas, 3000-456 Coimbra, Portugal
| | - Geraldine E Fahy
- Department of Biology, Pólo da Mitra, University of Évora, 7002-554 Évora, Portugal
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
| | - Daniela Anselmo
- Department of Biology, Pólo da Mitra, University of Évora, 7002-554 Évora, Portugal
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
| | - Teresa Fernandes
- Department of Biology, Pólo da Mitra, University of Évora, 7002-554 Évora, Portugal
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
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Cotrina Luque J, Rei MJ, Capoulas M, Santos C, Raimundo P. The role of clinical pharmacists in patients with suspected allergy to β-lactams: A systematic review. Farm Hosp 2024; 48:38-44. [PMID: 37696709 DOI: 10.1016/j.farma.2023.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVE To analyze the role played by the clinical pharmacist and its impact in antibiotic stewardship facing suspected allergy to beta-lactam antibiotics. METHOD We performed two different independent bibliographic searches. A total of 35 articles were found, and the final number included in the study was 12. We analysed the articles and collected variables of efficacy, safety and applicability of evaluation tools applied to patients with suspected allergy to beta-lactams. Also, the variation in the consumption and prescription profile of alternative antibiotics was analyzed. RESULTS The selected studies analysed questionnaires, allergy delabeling, intradermal tests and oral challenge tests performed by pharmacists. Significant differences in the efficacy endpoint were found in 4 studies in favour of pharmaceutical intervention. In the study of Kwiatkowski et al, cefazolin use increased in surgical patients after pharmacist intervention (65 vs. 28%; p < 0.01). In a quasi-experimental study, the mean defined daily dose of aztreonam and the mean days of therapy per 1000 patients/day decreased (21.23 vs 9.05, p <0.01) and (8.79-4.24, p = 0.016), pre and post-intervention, respectively, increasing antibiotic de-escalations (p ≤ 0.01). In another quasi-experimental study, the prescription of restricted-use antibiotics decreased (42.5% vs. 17.9%, p < 0.01) and the use of pre-surgical prophylactic antibiotics alternative to cefazolin (81.9% vs 55.9%, p<0.01) in another study. Other study showed that the mean time per interview was 5.2 minutes per patient. No adverse events were reported in any study. CONCLUSION The pharmacist intervention in the evaluation of the patient with suspected allergy to beta-lactams is effective, safe and feasible to implement on daily clinical practice. The standardization of protocols to clarify the history of allergies and development of evaluation tools represent simple screenings to perform delabelling or refer to the Immunoallergology service, improving penicilins use and reducing the need for second line antibiotics. More studies are needed to standardize the desensitization tests made by pharmacists. However, despite these results, the involvement and leadership of the pharmacist in this area is limited and constitutes a future challenge for the profession.
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Affiliation(s)
| | - Maria José Rei
- Servicios Farmacéuticos, Hospital Da Luz, Lisboa, Portugal
| | | | - Cláudia Santos
- Servicios Farmacéuticos, Hospital Da Luz, Lisboa, Portugal
| | - Pedro Raimundo
- Servicio de Medicina Intensiva, Hospital Da Luz, Lisboa, Portugal
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Cotrina Luque J, Rei MJ, Capoulas M, Santos C, Raimundo P. [Translated article] The role of clinical pharmacists in patients with suspected allergy to β-lactams: A systematic review. Farm Hosp 2024; 48:T38-T44. [PMID: 37953114 DOI: 10.1016/j.farma.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/28/2023] [Indexed: 11/14/2023] Open
Abstract
OBJECTIVE To analyze the role played by the clinical pharmacist and its impact in antibiotic stewardship facing suspected allergy to beta-lactam antibiotics. METHOD We performed 2 different independent bibliographic searches. A total of 35 articles were found, and the final number included in the study was 12. We analyzed the articles and collected variables of efficacy, safety, and applicability of evaluation tools applied to patients with suspected allergy to beta-lactams. Also, the variation in the consumption and prescription profile of alternative antibiotics was analyzed. RESULTS The selected studies analyzed questionnaires, allergy delabeling, intradermal tests, and oral challenge tests performed by pharmacists. Significant differences in the efficacy endpoint were found in 4 studies in favor of pharmaceutical intervention. In the study of Kwiatkowski et al., cefazolin use increased in surgical patients after pharmacist intervention (65% vs 28%; P < .01). In a quasi-experimental study, the mean defined daily dose of aztreonam and the mean days of therapy per 1000 patients/day decreased (21.23 vs 9.05, P <.01) and (8.79-4.24, P = .016), pre- and post-intervention, respectively, increasing antibiotic de-escalations (P = < .01). In another quasi-experimental study, the prescription of restricted use antibiotics decreased (42.5% vs 17.9%, P < .01)and the use of pre-surgical prophylactic antibiotics alternative to cefazolin (81.9% vs 55.9%, P < .01)in another study. Other study showed that the mean time per interview was 5.2 min per patient. No adverse events were reported in any study. CONCLUSION The pharmacist intervention in the evaluation of the patient with suspected allergy to beta-lactams is effective, safe, and feasible to implement on daily clinical practice. The standardization of protocols to clarify the history of allergies and development of evaluation tools represent simple screenings to perform delabeling or refer to the Immunoallergology service, improving penicilins use and reducing the need for second-line antibiotics. More studies are needed to standardize the desensitization tests made by pharmacists. However, despite these results, the involvement and leadership of the pharmacist in this area is limited and constitutes a future challenge for the profession.
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Affiliation(s)
| | - Maria José Rei
- Servicios Farmacéuticos, Hospital Da Luz Lisboa, Lisboa, Portugal
| | - Miriam Capoulas
- Servicios Farmacéuticos, Hospital Da Luz Lisboa, Lisboa, Portugal
| | - Cláudia Santos
- Servicios Farmacéuticos, Hospital Da Luz Lisboa, Lisboa, Portugal
| | - Pedro Raimundo
- Servicio de Medicina Intensiva, Hospital Da Luz Lisboa, Lisboa, Portugal
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Rebelo P, Teixeira A, Pinto R, Santos C, Brooks D, Marques A. Intensity of exercise in people with COPD enrolled in community-based physical activities. Pulmonology 2023:S2531-0437(23)00199-X. [PMID: 38008703 DOI: 10.1016/j.pulmoe.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/25/2023] [Accepted: 11/02/2023] [Indexed: 11/28/2023] Open
Affiliation(s)
- P Rebelo
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro, Aveiro, Portugal; iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - A Teixeira
- City council of Estarreja, Sports division, Estarreja, Portugal
| | - R Pinto
- City council of Estarreja, Sports division, Estarreja, Portugal
| | - C Santos
- City council of Estarreja, Sports division, Estarreja, Portugal
| | - D Brooks
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada; West Park Healthcare Centre, Toronto, ON, Canada
| | - A Marques
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro, Aveiro, Portugal; iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal.
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Castelo F, Santos C, Costa B, Sousa R, Ricardo R, Batista P, Ribeiro D. Wide-Awake Local Anesthesia No Tourniquet for Rhizarthrosis Surgery: Technique and Experience for 16 Consecutive Cases. Cureus 2023; 15:e45705. [PMID: 37876397 PMCID: PMC10591532 DOI: 10.7759/cureus.45705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 10/26/2023] Open
Abstract
Since it was described, wide-awake local anaesthesia no tourniquet (WALANT) has gained popularity. Our department has started using WALANT for hand surgery with increasing complexity. We present our results with WALANT rhizarthrosis surgery, including prosthetic replacement, trapeziectomy with suture button suspensionplasty and revision surgery. A retrospective review of all rhizarthrosis procedures under WALANT was performed from April 2021 to July 2022. We included patients who fulfilled inclusion criteria and had adequate imaging and clinical follow-up. A satisfaction survey was performed by telephone. Surgical time, complications, conversion to conventional anesthesia, pain, anxiety and global satisfaction were recorded. Tumescent anesthesia is performed 20-25 minutes before surgery, and is performed in four or five strategic locations that allow adequate anesthesia and vasoconstriction for the procedure to be comfortably carried out. We observed a series of 16 sequential surgeries involving 14 patients. All were female with a mean age of 65 years. Fourteen cases were performed due to primary rhizarthrosis, eight trapeziectomies with suture button suspensionplasty, six prosthetic replacements, and two revision surgeries. One patient needed to be converted to conventional anaesthesia due to anxiety during the procedure. Mean procedure time was 73 minutes. There were no WALANT-related complications. Mean patient-reported satisfaction with the anesthetic technique was a 9 (on a scale from 1 to 10) and 100% of patients would choose to undergo surgery with WALANT anesthesia for a future procedure. We find it useful to actively engage the patients during surgery to keep them comfortable and also help the surgeons assess stability and functional results. After wound closure, the hand is shown to the patient and he performs various tasks. There is somewhat of a learning curve for rhizarthrosis surgery under WALANT; patient comfort can be achieved through an adequate anesthetic technique and reassurance before and during surgery. We recommend that the first few cases be done in the presence of an anesthesiologist and a fasting patient in case there is a need to convert to conventional anesthesia. Wide awake rhizarthrosis surgery, even revision surgery, is safe and pain-free. Patient-reported satisfaction is also high. The authors find that including patient participation in their own surgery might be promising for post-op rehabilitation. There are limitations in this study such as the absence of a control conventional anesthesia group, the satisfaction questionnaire was not done immediately post-operatively, as such, a memory bias cannot be excluded, and it is not yet validated for the Portuguese population.
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Affiliation(s)
- Filipe Castelo
- Orthopaedics and Trauma, Centro Hospitalar Universitário Cova da Beira, Covilhã, PRT
| | - Cláudia Santos
- Orthopaedics and Trauma, Centro Hospitalar Universitário Cova da Beira, Covilhã, PRT
| | - Bárbara Costa
- Orthopaedics and Trauma, Centro Hospitalar Universitário Cova da Beira, Covilhã, PRT
| | - Ricardo Sousa
- Orthopaedics and Trauma, Centro Hospitalar Universitário Cova da Beira, Covilhã, PRT
| | - Raquel Ricardo
- Orthopaedics and Trauma, Centro Hospitalar Universitário Cova da Beira, Covilhã, PRT
| | - Pedro Batista
- Orthopaedics and Trauma, Centro Hospitalar Universitário Cova da Beira, Covilhã, PRT
| | - Daniel Ribeiro
- Orthopaedics and Trauma, Centro Hospitalar Universitário Cova da Beira, Covilhã, PRT
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Santos C, Valentim AM, Félix L, Balça-Silva J, Pinto MLR. Longitudinal effects of ketamine on cell proliferation and death in the CNS of zebrafish. Neurotoxicology 2023; 97:78-88. [PMID: 37196828 DOI: 10.1016/j.neuro.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/12/2023] [Accepted: 05/13/2023] [Indexed: 05/19/2023]
Abstract
Zebrafish is known for its widespread neurogenesis and regenerative capacity, as well as several biological advantages, which turned it into a relevant animal model in several areas of research, namely in toxicological studies. Ketamine is a well-known anesthetic used both in human as well as veterinary medicine, due to its safety, short duration and unique mode of action. However, ketamine administration is associated with neurotoxic effects and neuronal death, which renders its use on pediatric medicine problematic. Thus, the evaluation of ketamine effects administration at early stages of neurogenesis is of pivotal importance. The 1-4 somites stage of zebrafish embryo development corresponds to the beginning of segmentation and formation of neural tube. In this species, as well as in other vertebrates, longitudinal studies are scarce, and the evaluation of ketamine long-term effects in adults is poorly understood. This study aimed to assess the effects of ketamine administration at the 1-4 somites stage, both in subanesthetic and anesthetic concentrations, in brain cellular proliferation, pluripotency and death mechanisms in place during early and adult neurogenesis. For that purpose, embryos at the 1-4 somites stage (10,5hours post fertilization - hpf) were distributed into study groups and exposed for 20minutes to ketamine concentrations at 0.2/0.8mg/mL. Animals were grown until defined check points, namely 50 hpf, 144 hpf and 7 months adults. The assessment of the expression and distribution patterns of proliferating cell nuclear antigen (PCNA), of sex-determining region Y-box 2 (Sox 2), apoptosis-inducing factor (AIF) and microtubule-associated protein 1 light chain 3 (LC3) was performed by Western-blot and immunohistochemistry. The results evidenced the main alterations in 144 hpf larvae, namely in autophagy and in cellular proliferation at the highest concentration of ketamine (0.8mg/mL). Nonetheless, in adults no significant alterations were seen, pointing to a return to a homeostatic stage. This study allowed clarifying some of the aspects pertaining the longitudinal effects of ketamine administration regarding the CNS capacity to proliferate and activate the appropriate cell death and repair mechanisms leading to homeostasis in zebrafish. Moreover, the results indicate that ketamine administration at 1-4 somites stage in the subanesthetic and anesthetic concentrations despite some transitory detrimental effects at 144 hpf, is long-term safe for CNS, which are newly and promising results in this research field.
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Affiliation(s)
- C Santos
- Escola Universitária Vasco da Gama (EUVG), Centro de Investigação Vasco da Gama (CIVG), EUVG, Coimbra, Portugal; Faculdade de Medicina da Universidade de Coimbra (FMUC), Coimbra, Portugal; Centro de Ciência Animal e Veterinária (CECAV), Universidade de Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal
| | - A M Valentim
- Instituto de Investigação e Inovação em Saúde (i3S), Instituto de Biologia Molecular e Celular (IBMC), Universidade do Porto, Porto, Portugal
| | - L Félix
- Centro de Investigação e de Tecnologias Agroambientais e Biológicas (CITAB), UTAD, Vila Real
| | - J Balça-Silva
- NOVA Medical School - Faculdade de Ciências Médicas, Universidade Nova de Lisboa (FCM-UNL), Lisboa, Portugal
| | - M L R Pinto
- Centro de Ciência Animal e Veterinária (CECAV), Universidade de Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal.
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Santos C, Santos C, Almeida A. Malnutrition Risk In Gastrointestinal Cancer Patients And Its Association With Disease Burden. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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Freire L, Santos C, Duarte F, Tavares C, Silva CQ. A Rare Complication of Actinomyces Abdominal Infection: A Case Report. Cureus 2023; 15:e36524. [PMID: 37090375 PMCID: PMC10121248 DOI: 10.7759/cureus.36524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 04/25/2023] Open
Abstract
Intraabdominal infection by Actinomyces species, although a rare condition, usually occurs after a disruption of the mucosal barrier in a peritoneal organ. This infection is characterized by the development of an extended and persistent inflammatory and fibrotic reaction that can be mistaken for other pathogens or different etiologies, like tumors or inflammatory diseases. It can present as an abscess, a stricturing tissue with multiple adhesions, and/or a fistulization. Early diagnosis, targeted and prolonged antimicrobial therapy, and optimal drainage when indicated, are the key to success. The authors present a case where laparotomic hysterectomy was complicated by a superficial and an organ/space surgical site infection due to Actinomyces with a posterior developing of a colo-vaginal fistula that was treated surgically.
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Affiliation(s)
- Lígia Freire
- General Surgery, Hospital Pedro Hispano, Matosinhos, PRT
| | - Cláudia Santos
- General Surgery, Hospital Pedro Hispano, Matosinhos, PRT
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Quaresma MAG, Pereira G, Nunes ML, Sponda C, Jardim A, Gonçalves H, Santos C, Roseiro LC. Evaluating dried salted cod amino acid signature for nutritional quality assessment and discriminant analysis. Front Nutr 2023; 10:1144713. [PMID: 37125032 PMCID: PMC10140297 DOI: 10.3389/fnut.2023.1144713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/14/2023] [Indexed: 05/02/2023] Open
Abstract
Aim Thus, the aim of this study was to answer three scientific questions: (1) Are the protein content and amino acid profile of dried salted cod influenced by species (Gadus morhua and Gadus macrocephalus)? (2) Are the protein content and amino acid profile of dried salted cod influenced by the geographical area of capture (Iceland and Norway)? and (3) Does the amino acid profile have the potential to be used as a discriminator of species and geographical areas of capture? Methods A total of 45 dried salted cods (2-3 kg of dry weight; n = 15 samples/origin) were used in this study. The Atlantic cod was fished in the Atlantic northeast (FAO 27 area) within the Exclusive Economic zones (EEZ) of Norway (n = 15) and Iceland (n = 15), while the Pacific cod was caught in the Pacific northeast (FAO 67 area) within the Alaska EEZ (n = 15). Total protein content was determined by the Kjeldahl method, in accordance with the AOAC procedures. The amino acid profile was analyzed by HPLC with fluorescence detection (at excitation and emission wavelengths of 338 and 425 nm, respectively). Results The Atlantic cod presented higher contents of total protein (33.90 versus 33.10 g/100 g of cod edible portion; p = 0.017) and total amino acid contents (32.52 versus 32.04 g/100 g of cod edible portion; p = 0.015) but displayed lower percentage of indispensable amino acids (32.16 versus 32.83 g/100 g of protein; p < 0.001) than Pacific cod. Among the Atlantic cod harvesting locations, the Norwegian cod displayed higher total amino acid contents (96.91 versus 96.81 g/100 g of protein; p = 0.012) and higher percentage of indispensable amino acids (35.38 versus 28.94 g/100 g of protein; p = 0.042) than the Icelandic counterpart. A correct classification of 100% was obtained for the Pacific and Icelandic cod varieties, but the classification accuracy in the Norwegian cod was of just 86.67%, since 2 samples out of 15 were incorrectly classified as Icelandic. Conclusion The comparison of cod species showed that the Atlantic cod had a significantly lower EAAI than the Pacific cod (p < 0.001; 88.23 versus 88.61). On the other hand, the comparison of the two origins in the Atlantic cod, showed that Norwegian cod displayed a significantly higher EAAI than the Icelandic cod (99.15 versus 77.32). The assessment of the EAAI allows the classification of the protein's nutritional quality, allowing us to classify both cod species as a good protein source to human diet. However, within the Atlantic cod, the Norwegian cod's protein is classified as high quality, while the Icelandic cod attain the classification of useful quality. Regarding the amino acid profile discriminatory potential to classify cod samples. The results show that the AA profile has 100% accuracy in the separation of cod species, but was not globally efficient in the differentiation of the Norwegian from the Icelandic cod.
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Affiliation(s)
- M. A. G. Quaresma
- CIISA—Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
- AL4AnimalS—Associate Laboratory for Animal and Veterinary Sciences, Lisbon, Portugal
- *Correspondence: M. A. G. Quaresma,
| | - G. Pereira
- CIISA—Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
- AL4AnimalS—Associate Laboratory for Animal and Veterinary Sciences, Lisbon, Portugal
| | - M. L. Nunes
- CIIMAR, Interdisciplinary Centre of Marine and Environmental Research, Terminal de Cruzeiros do Porto de Leixões, University of Porto, Matosinhos, Portugal
| | - C. Sponda
- CIISA—Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
- AL4AnimalS—Associate Laboratory for Animal and Veterinary Sciences, Lisbon, Portugal
| | - A. Jardim
- Food and Veterinary Department of Setúbal, General Directorate of Food and Veterinary (DGAV), Setúbal, Portugal
| | - H. Gonçalves
- Food Technology and Safety Division, National Institute for Agricultural and Veterinary Research (INIAV, IP), Quinta do Marquês, Oeiras, Portugal
| | - C. Santos
- Food Technology and Safety Division, National Institute for Agricultural and Veterinary Research (INIAV, IP), Quinta do Marquês, Oeiras, Portugal
| | - L. C. Roseiro
- Food Technology and Safety Division, National Institute for Agricultural and Veterinary Research (INIAV, IP), Quinta do Marquês, Oeiras, Portugal
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Bedford J, Martin P, Crowe S, Wagstaff D, Santos C, Singleton G, Baumber R, Vindrola‐Padros C, Vohra R, Swart M, Oliver CM, Dorey J, Leeman I, Moonesinghe SR. Development and internal validation of a model for postoperative morbidity in adults undergoing major elective colorectal surgery: the peri-operative quality improvement programme (PQIP) colorectal risk model. Anaesthesia 2022; 77:1356-1367. [PMID: 36130834 PMCID: PMC9826419 DOI: 10.1111/anae.15858] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2022] [Indexed: 01/11/2023]
Abstract
Over 1.5 million major surgical procedures take place in the UK NHS each year and approximately 25% of patients develop at least one complication. The most widely used risk-adjustment model for postoperative morbidity in the UK is the physiological and operative severity score for the enumeration of mortality and morbidity. However, this model was derived more than 30 years ago and now overestimates the risk of morbidity. In addition, contemporary definitions of some model predictors are markedly different compared with when the tool was developed. A second model used in clinical practice is the American College of Surgeons National Surgical Quality Improvement Programme risk model; this provides a risk estimate for a range of postoperative complications. This model, widely used in North America, is not open source and therefore cannot be applied to patient populations in other settings. Data from a prospective multicentre clinical dataset of 118 NHS hospitals (the peri-operative quality improvement programme) were used to develop a bespoke risk-adjustment model for postoperative morbidity. Patients aged ≥ 18 years who underwent colorectal surgery were eligible for inclusion. Postoperative morbidity was defined using the postoperative morbidity survey at postoperative day 7. Thirty-one candidate variables were considered for inclusion in the model. Death or morbidity occurred by postoperative day 7 in 3098 out of 11,646 patients (26.6%). Twelve variables were incorporated into the final model, including (among others): Rockwood clinical frailty scale; body mass index; and index of multiple deprivation quintile. The C-statistic was 0.672 (95%CI 0.660-0.684), with a bootstrap optimism corrected C-statistic of 0.666 at internal validation. The model demonstrated good calibration across the range of morbidity estimates with a mean slope gradient of predicted risk of 0.959 (95%CI 0.894-1.024) with an index-corrected intercept of -0.038 (95%CI -0.112-0.036) at internal validation. Our model provides parsimonious case-mix adjustment to quantify risk of morbidity on postoperative day 7 for a UK population of patients undergoing major colorectal surgery. Despite the C-statistic of < 0.7, our model outperformed existing risk-models in widespread use. We therefore recommend application in case-mix adjustment, where incorporation into a continuous monitoring tool such as the variable life adjusted display or exponentially-weighted moving average-chart could support high-level monitoring and quality improvement of risk-adjusted outcome at the population level.
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Affiliation(s)
- J. Bedford
- UCLH Surgical Outcomes Research Centre, Department of Anaesthesia and Peri‐operative MedicineUniversity College London Hospitals NHS Foundation TrustLondonUK,Centre for Peri‐operative Medicine, Research Department for Targeted InterventionUCL Division of Surgery and Interventional ScienceLondonUK
| | - P. Martin
- Department of Applied Health ResearchUniversity College LondonUK
| | - S. Crowe
- Clinical Operational Research UnitUniversity College LondonUK
| | - D. Wagstaff
- UCLH Surgical Outcomes Research Centre, Department of Anaesthesia and Peri‐operative MedicineUniversity College London Hospitals NHS Foundation TrustLondonUK,Centre for Peri‐operative Medicine, Research Department for Targeted InterventionUCL Division of Surgery and Interventional ScienceLondonUK
| | - C. Santos
- Health Services Research Centre, National Institute for Academic AnaesthesiaRoyal College of AnaesthetistsLondonUK
| | - G. Singleton
- Centre for Peri‐operative MedicineResearch Department for Targeted InterventionUCL Division of Surgery and Interventional ScienceLondonUK
| | - R. Baumber
- Department of AnaesthesiaRoyal National Orthopaedic Hospital NHS TrustLondonUK
| | - C. Vindrola‐Padros
- Research Department for Targeted InterventionUCL Division of Surgery and Interventional ScienceLondonUK
| | - R. Vohra
- Department of SurgeryNottingham University Hospitals NHS TrustNottinghamUK
| | - M. Swart
- Department of AnaesthesiaTorbay and South Devon NHS TrustDevonUK
| | - C. M. Oliver
- UCLH Surgical Outcomes Research Centre, Department of Anaesthesia and Peri‐operative MedicineUniversity College London Hospitals NHS Foundation TrustLondonUK,Centre for Peri‐operative MedicineResearch Department for Targeted InterventionUCL Division of Surgery and Interventional ScienceLondonUK
| | - J. Dorey
- Lay CommitteeRoyal College of Anaesthetists and Lay representatives PQIP Project teamLondonUK
| | - I. Leeman
- Lay CommitteeRoyal College of Anaesthetists and Lay representatives PQIP Project teamLondonUK
| | - S. R. Moonesinghe
- UCLH Surgical Outcomes Research Centre, Department of Anaesthesia and Peri‐operative MedicineUniversity College London Hospitals NHS Foundation TrustLondonUK,Centre for Peri‐operative Medicine, Research Department for Targeted InterventionUCL Division of Surgery and Interventional ScienceLondonUK
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Muacevic A, Adler JR, Couceiro C, Santos C, Araujo AV, Alegre I, Santos C, Campos Costa F, Cardoso D, Cardoso V, Sampaio R, Cardoso F, Gascón P. Prevalence of Imaging-Detected Silent Female Breast Cancer in Autopsy Specimens: A Study Using Image-Guided Biopsies. Cureus 2022; 14:e32776. [PMID: 36686129 PMCID: PMC9854332 DOI: 10.7759/cureus.32776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
Background This study was conducted to evaluate the prevalence of imaging-detected silent breast cancer in females, with the hypothesis that the incidence of imaging-detected silent breast cancer in females is greater than the true disease incidence. The main purpose of this study is the attempt to prove whether breast imaging can identify silent breast cancers that apparently are common in serial histology analysis. Methodology A series of 217 consecutive medicolegal autopsies on fresh Portuguese cadavers were performed from July 2016 to December 2019 at the National Institute of Legal Medicine and Forensic Science, Lisbon, Portugal. The criteria for exclusion were age younger than 40 years, the autopsy performed in less than 48 hours after death, any major injury to one or both breasts, and known or clinically evident breast cancer. Once the eligibility criteria were met, and the sample collection authorization was obtained, a bilateral subcutaneous modi-fied radical mastectomy was performed in each fresh cadaver at the National Institute of Legal Medicine and Forensic Science. Mammography, ecography, and excisional biopsies of suspect areas were conducted on the collected samples. Results The indication for excisional biopsy by imaging was assigned in eight cases, and no breast cancer was discovered in the excised specimens. Conclusions In light of the findings, it cannot be concluded that the imaging-detected silent breast cancer prevalence is higher than the actual incidence of the disease, so the author's initial hypothesis was rejected. Mammography does not overdiagnose breast cancer. Benign breast alterations are common, accounting for 43.6% of the corpses collected, while low-suspicion alterations were discovered in 1.84% of breast samples. The objective examination, which included inspection and palpation, missed 37.5% of the biopsied breast changes. This finding indicated that an objective examination leads to a significant number of false-negative results which cannot be used as a screening method.
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Rio BC, Lima MMS, Alves ADR, Santos VS, Lopes JIF, Santos C, Bastos L, Pinto MA, Oliveira JM, Filho LMA, Leon LAA. PARVOVIRUS B19 EM DOADORES DE SANGUE: AVALIAÇÃO DA INCIDÊNCIA E DO RISCO DE TRANSMISSÃO RESIDUAL POR TRANSFUSÃO SANGUÍNEA NO ESTADO DO RIO DE JANEIRO. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Tran T, Dym A, Rosania A, Nelson L, Ramdin C, Santos C. 91 The Promising Use of an Emergency Department Observation Unit to Manage Patients With Opioid Use Disorder. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ramos-Zaldívar H, Reyes-Perdomo K, Espinoza-Moreno N, Dox-Cruz E, Urbina T, Caballero A, Dominguez E, Calix S, Monterroso-Reyes J, Vásquez E, Ortiz T, Rodríguez-Machado H, Solis M, Silva I, Galeano M, Alvarado A, Medina A, Guerrero-Díaz L, Jiménez-Faraj J, Santos C, Arita W, Montufar D, Sabillón J, Sorto M, Navarro X, Palomo-Bermúdez V, Andino H, Guzman S, Reyes M, Pazf E, Enamorado J, Sagastume Y, Rivera A, Sarmiento C, Pineda X, Puerto V, Landaverde J, Reyes S, Perdomo I, Rivera J, Girón W, Sabillón K, Leiva P, Toro K, Montes-Gambarelli J, Flores C, Salas-Huenuleo E, Andia M. SAFETY AND EFFICACY OF THYMIC PEPTIDES IN THE TREATMENT OF HOSPITALIZED COVID-19 PATIENTS IN HONDURAS. Georgian Med News 2022:99-105. [PMID: 36427851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Coronavirus disease 2019 (Covid-19) active cases continue to demand the development of safe and effective treatments. This is the first clinical trial to evaluate the safety and efficacy of oral thymic peptides. ; We conducted a nonrandomized phase 2 trial with a historic control group to evaluate the safety and efficacy of a daily 250-mg oral dose of thymic peptides in the treatment of hospitalized Covid-19 patients. Comparisons based on standard care from registry data were performed after propensity score matching. The primary outcomes were survival, time to recovery, and number of participants with treatment-related adverse events or side effects by day 20. ; A total of 44 patients were analyzed in this study: 22 in the thymic peptide group and 22 in the standard care group. There were no deaths in the intervention group compared to 24% mortality in standard care by day 20 (log-rank P=0.02). Kaplan-Meier analysis showed a significantly shorter time to recovery by day 20 in the thymic peptide group than in the standard care group (median, 6 days vs. 12 days; hazard ratio for recovery, 2.75 [95% confidence interval, 1.34 to 5.62]; log-rank P=0.002). No side effects or adverse events were reported. ; In patients hospitalized with Covid-19, the use of thymic peptides resulted in no side effects, adverse events, or deaths by day 20. Compared with the registry data, a significantly shorter time to recovery and mortality reduction were measured.
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Affiliation(s)
- H Ramos-Zaldívar
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras; 2Doctoral Program in Medical Sciences, Faculty of Medicine, Pontificia Universidad Católica de Chile
| | - K Reyes-Perdomo
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras; 3Psiquiatría Infantil y del Adolescente, Hospital Barros Luco Trudeau, Facultad de Ciencias Médicas, Universidad de Santiago de Chile
| | - N Espinoza-Moreno
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - E Dox-Cruz
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - Th Urbina
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - A Caballero
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - E Dominguez
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - S Calix
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - J Monterroso-Reyes
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - E Vásquez
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - T Ortiz
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - H Rodríguez-Machado
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - M Solis
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - I Silva
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - M Galeano
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - A Alvarado
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - A Medina
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - L Guerrero-Díaz
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - J Jiménez-Faraj
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras; 4Hospital Civil de Guadalajara Juan I. Menchaca, México
| | - C Santos
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras; 5Hospital del Valle, San Pedro Sula, Honduras
| | - W Arita
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - D Montufar
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - J Sabillón
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - M Sorto
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - X Navarro
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - V Palomo-Bermúdez
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras; 5Hospital del Valle, San Pedro Sula, Honduras
| | - H Andino
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - S Guzman
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - M Reyes
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - E Pazf
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - J Enamorado
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - Y Sagastume
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - A Rivera
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - C Sarmiento
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - X Pineda
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - V Puerto
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - J Landaverde
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - S Reyes
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - I Perdomo
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - J Rivera
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - W Girón
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - K Sabillón
- 6Hospital Santa Bárbara Integrado, Santa Bárbara, Honduras
| | - P Leiva
- 7Triaje de Santa Bárbara, Secretaría de Salud de Honduras
| | - K Toro
- 7Triaje de Santa Bárbara, Secretaría de Salud de Honduras
| | - J Montes-Gambarelli
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras
| | - C Flores
- 1Grupo de Investigación Médica de la Universidad Católica de Honduras, (GIMUNICAH), Faculty of Medicine, Universidad Católica de Honduras; 8Laboratorio de Biología Molecular de San Pedro Sula, Secretaría de Salud de Honduras
| | | | - M Andia
- 10Biomedical Imaging Center Radiology Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; 11Millennium Nucleus in Cardiovascular Magnetic Resonance, Santiago, Chile
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Magalhaes B, Fernandes C, Santos C. CN4 iGestSaúde: Portuguese mobile application for the self-management of symptoms associated with chemotherapy treatment. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Gomes R, Santos C, Descalço N, Moutinho F. Does my lifestyle explain my depression? The role of exercise, diet and smoking in the prevention of depression. Eur Psychiatry 2022. [PMCID: PMC9567587 DOI: 10.1192/j.eurpsy.2022.1751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Depression as a public health concern highlights the importance of prevention. The nature of the disease is complex, linked to numerous biopsychosocial factors. However, it was found that healthiest lifestyle reduced 67% the risk of depressive symptoms. Objectives To review evidence on how exercise, diet, and smoking impact on the risk of depression. Methods Non-systematic review of literature through search on PubMed/MEDLINE following the terms “Lifestyles”,“risk” and “depression”. Results Several studies have shown that exercise reduces the incidence of depressive symptoms and major depressive disorder regardless of intensity, geographic region, age, gender, or follow-up period. Smoking significantly increases the risk of depression, including the ones exposed to second-hand smoking and pregnant women in which prenatal smoking was associated with a three-fold increased risk of postpartum depression. The Mediterranean diet rich in complex carbohydrates, omega-3 fatty acids, B-group vitamins and several amino acids have shown a negative association with the incidence of depression. A high frequency of breakfast consumption, an increased intake of fruits, vegetables, and some specific nutrients (zinc, iron, magnesium, vitamins, and folate) was also inversely correlated with prevalence of depressive symptoms. On the other hand, western dietary patterns, with sweetened beverages, processed food, and foods rich in saturated fatty acids, have been linked to an increased risk. Skipping meals and snacking on unhealthy food also contributes to depressive symptoms. Conclusions Relatively modest changes in population diet, tobacco consumption and levels of exercise may have important public mental health benefits preventing a substantial number of new cases of depression. Disclosure No significant relationships.
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Turato E, Rodrigues J, Santos C, Bispo A, Lima C. Is the Living Will an interesting way to determine themselves? Qualitative research about considerations said by oncologists in a university service care in Southeast Brazil. Eur Psychiatry 2022. [PMCID: PMC9566877 DOI: 10.1192/j.eurpsy.2022.1694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction What does the physician think in his/her intimacy about clinical care for when his/her death would be near? Living Will is a type of advance directive with the aim to guarantee the testator’s autonomy when faced with death. Particularly oncologists are often faced with human finitude. Their delicate work does not protect them from the possible anguish of thinking and preparing for their own death. It is pertinent to know the psychic mechanisms normally present in the management of this expectation. Objectives To explore symbolic representations of oncologists such as referred to the possible elaboration of their own Living Will. Methods Qualitative design. Eight participants, clinicians, sample closed by theoretical saturation of information. Semidirected interviews in-depth were conducted online during the pandemic, fully transcribed. Technique of Clinical-Qualitative Content Analysis used for data treatment to generate categories of discussion. The authors search for core meanings in the corpus of interviews, after free-floating readings. Results Three categories emerged from the material: Living Will: postponing the decision in order to not anticipate death; From Rationalization Mechanism to Intellectualization: a more sophisticated defensive strategy; Loss of Autonomy: the doctor’s belief while to feel him/herself patient. Conclusions (1) Even with all scientific knowledge, respondents have archaic thoughts on defining advance directives as healthy individuals would mean rushing time of their death. (2) Resistance of these professionals to an imagined scenario of end reveals underlying anguish in writing of living will. (3) There is fear of losing autonomy when they do not know how their Living Will can be seen. Disclosure No significant relationships.
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Gomes R, Santos C, Descalço N, Moutinho F. Apathy - where do we find it and how to treat. Eur Psychiatry 2022. [PMCID: PMC9568103 DOI: 10.1192/j.eurpsy.2022.2275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Although defined heterogeneously within the literature apathy is classified as a multidimensional deficit with emotional, behavioral, and cognitive domains in which there is a decrease in self-motivated/goal-directed activity. Recently conceptualized as a syndrome but lacking a universal screening tool.
Objectives
Review current knowledge on apathy and its best therapeutic approach.
Methods
Non-systematic review of literature through search on PubMed/MEDLINE following the terms “apathy”and“psychiatry”.
Results
Apathy is amongst the most frequent symptoms of dementia and highly prevalent across different forms and stages of dementia, including mild cognitive impairment (MCI) as well as other neurodegenerative and psychiatric disorders such as Parkinson’s disease (PD), Schizophrenia, Depression and Brain Injury. Individuals with apathy have higher frequencies of cognitive impairment and are less likely to be compliant/respond to treatment for comorbid illnesses. Apathy reduces quality of life, increases mortality and leads to caregivers distress - often identified as the most burdensome symptom. Once treatment should favor dopaminergic neurotransmission, psychostimulants were considered. Methylphenidate showed encouraging results as well as dopamine agonists but both with limited evidence. Atypical antipsychotics(APs) seem beneficial compared to typical APs. Antidepressants did not improve symptoms and may even worsen them. Previously reported benefits of acetylcholinesterase inhibitors (AChEIs) were not replicated in recent studies except for rivastigmine in PD. Nonpharmacological interventions are also important.
Conclusions
Apathy occurs frequently in a broad range of neuropsychiatric conditions and considering its impact on patients´ quality of life more studies are needed to find an efficient treatment. A consensus regarding definition and screening tools would allow a better approach.
Disclosure
No significant relationships.
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Zegre M, Barros J, Ribeiro IAC, Santos C, Caetano LA, Gonçalves L, Monteiro Resource FJ, Ferraz MP, Bettencourt A. Poly(DL-lactic acid) scaffolds as a bone targeting platform for the co-delivery of antimicrobial agents against S. aureus-C. albicans mixed biofilms. Int J Pharm 2022; 622:121832. [PMID: 35595042 DOI: 10.1016/j.ijpharm.2022.121832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
New strategies for the treatment of polymicrobial bone infections are required. In this study, the co-delivery of two antimicrobials by poly(D,L-lactic acid) (PDLLA) scaffolds was investigated in a polymicrobial biofilm model. PDLLA scaffolds were prepared by solvent casting/particulate leaching methodology, incorporating minocycline and voriconazole as clinically relevant antimicrobial agents. The scaffolds presented a sponge-like appearance, suitable to support cell proliferation and drug release. Single- and dual-species biofilm models of Staphylococcus aureus and Candida albicans were developed and characterized. S. aureus presented a higher ability to form single-species biofilms, compared to C. albicans. Minocycline and voriconazole-loaded PDLLA scaffolds showed activity against S. aureus and C. albicans single- and dual-biofilms. Ultimately, the cytocompatibility/functional activity of PDLLA scaffolds observed in human MG-63 osteosarcoma cells unveil their potential as a next-generation co-delivery system for antimicrobial therapy in bone infections.
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Affiliation(s)
- M Zegre
- Research Institute for Medicines (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, Av. Prof. Gama Pinto, 1649-003, Lisboa, Portugal; H&TRC - Centro de Investigação em Saúde e Tecnologia, ESTeSL - Escola Superior de Tecnologia da Saúde de Lisboa, IPL - Instituto Politécnico de Lisboa, Av. D. João II, Lote 4.69.01, 1990-096, Lisboa, Portugal
| | - J Barros
- i3S - Instituto de Investigação e Inovação em Saúde - Associação, Universidade do Porto, R. Alfredo Allen 208, 4200-135, Porto, Portugal; INEB - Instituto de Engenharia Biomédica, Universidade do Porto, R. Alfredo Allen 208, 4200-135, Porto, Portugal
| | - I A C Ribeiro
- Research Institute for Medicines (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, Av. Prof. Gama Pinto, 1649-003, Lisboa, Portugal
| | - C Santos
- CQE - Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais 1049-001,Lisboa, Portugal; EST Setúbal, CDP2T, Instituto Politécnico de Setúbal, Campus IPS, 2910 Setúbal,Portugal
| | - L A Caetano
- Research Institute for Medicines (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, Av. Prof. Gama Pinto, 1649-003, Lisboa, Portugal; H&TRC - Centro de Investigação em Saúde e Tecnologia, ESTeSL - Escola Superior de Tecnologia da Saúde de Lisboa, IPL - Instituto Politécnico de Lisboa, Av. D. João II, Lote 4.69.01, 1990-096, Lisboa, Portugal
| | - L Gonçalves
- Research Institute for Medicines (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, Av. Prof. Gama Pinto, 1649-003, Lisboa, Portugal
| | - F J Monteiro Resource
- i3S - Instituto de Investigação e Inovação em Saúde - Associação, Universidade do Porto, R. Alfredo Allen 208, 4200-135, Porto, Portugal; INEB - Instituto de Engenharia Biomédica, Universidade do Porto, R. Alfredo Allen 208, 4200-135, Porto, Portugal; FEUP/DEMM - Departamento de Engenharia Metalúrgica e de Materiais, Faculdade de Engenharia da Universidade do Porto, 4200-465 Porto, Portugal
| | - M P Ferraz
- i3S - Instituto de Investigação e Inovação em Saúde - Associação, Universidade do Porto, R. Alfredo Allen 208, 4200-135, Porto, Portugal; INEB - Instituto de Engenharia Biomédica, Universidade do Porto, R. Alfredo Allen 208, 4200-135, Porto, Portugal; FEUP/DEMM - Departamento de Engenharia Metalúrgica e de Materiais, Faculdade de Engenharia da Universidade do Porto, 4200-465 Porto, Portugal.
| | - A Bettencourt
- Research Institute for Medicines (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, Av. Prof. Gama Pinto, 1649-003, Lisboa, Portugal.
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Maximiano M, Santos L, Santos C, Aragão F, Dias S, Franco O, Mehta A. Host induced gene silencing of Sclerotinia sclerotiorum effector genes for the control of white mold. Biocatalysis and Agricultural Biotechnology 2022. [DOI: 10.1016/j.bcab.2022.102302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Alves M, Simba B, Fernandes M, Elias C, Amarante J, Santos C. Effect of Roughness on Flexural Strength of Dental Lithium-Disilicate. Dent Mater 2022. [DOI: 10.1016/j.dental.2021.12.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Viana R, Carvalho L, Santos C. Congenital pulmonary airway malformation: A rare diagnosis in adulthood. Respirol Case Rep 2022; 10:e0895. [PMID: 34976401 PMCID: PMC8688662 DOI: 10.1002/rcr2.895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/02/2021] [Accepted: 12/07/2021] [Indexed: 11/24/2022] Open
Abstract
This paper consists of a clinical image of a complex developmental anomaly that is usually diagnosed prenatally or during childhood. Its detection in adult life is very rare, as happened in the present case.
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Affiliation(s)
- Raquel Viana
- Pulmonology DepartmentCentro Hospitalar de LeiriaLeiriaPortugal
| | - Lina Carvalho
- Anatomical Pathology UnitCentro Hospitalar Universitário de CoimbraCoimbraPortugal
| | - Cláudia Santos
- Pulmonology DepartmentCentro Hospitalar de LeiriaLeiriaPortugal
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Baptista I, Gomes F, Vieira S, Ferreira S, Alves M, Santos C, Fernandes M. Functionalization of Restorative Dental Glass-Ceramics with Bactericidal Properties. Dent Mater 2022. [DOI: 10.1016/j.dental.2021.12.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jacob K, Bernardes D, Rosa M, Santos C, Monteiro I, Escolástico A, Coelho M, Jordão J, Fernandez G, Souto C. Acceptance procedure for beam-matched linacs. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00152-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Quaresma MAG, Antunes IC, Ferreira BG, Parada A, Elias A, Barros M, Santos C, Partidário A, Mourato M, Roseiro LC. The composition of the lipid, protein and mineral fractions of quail breast meat obtained from wild and farmed specimens of Common quail (Coturnix coturnix) and farmed Japanese quail (Coturnix japonica domestica). Poult Sci 2021; 101:101505. [PMID: 34818612 PMCID: PMC8626699 DOI: 10.1016/j.psj.2021.101505] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/16/2021] [Accepted: 09/22/2021] [Indexed: 11/25/2022] Open
Abstract
The present study was intended to answer 2 scientific hypotheses: 1) the quail species has a significant influence in quail breast meat composition; 2) the wild quail's meat presents healthier composition than their farmed counterparts. An analysis of the pectoral muscles of wild and captive common quails (Coturnix coturnix) and domestic quails (Coturnix japonica domestica) was performed. The content of fatty acids (FA), amino acids, total cholesterol, and vitamin E, some basic macro- and microminerals in the pectoral muscles of the 2 species of the genus Coturnix were analyzed. Regarding the quail species influence on meat composition, Japanese Quail (JQ) revealed better lipid composition, characterized by lower saturated FA (SFA; less 3.17 g/100 g of total fatty acids), higher polyunsaturated FA contents (PUFA; more 5.5 g/100 g of total fatty acids) and healthier polyunsaturated FA/saturated FA (P/S) and n-6/n-3 ratios and TI value (1.08, 9.54 and 0.60 vs. 0.76, 12.58, and 0.75, correspondingly). The absence of differences observed on amino acids partial sums and ratios reveals equality between species on protein nutritional quality. On the other hand, Common Quail (CQ) proved to be a better source of copper (0.181 mg/100 g of meat), iron (2.757 mg/100 g of meat), manganese (0.020 mg/100 g of meat), and zinc (0.093 mg/100 g of meat) than JQ. The comparison of farmed and wild specimens within CQ, showed that wild birds presented lower total cholesterol (less 8.32 mg/g of fresh meat) and total PUFA (less 4.26 g/100 g of total fatty acids), and higher n-3 PUFA contents (more 1.53 g/100 g of total fatty acids), which contributed to healthier P/S and n-6/n-3 ratios, but worst PI (1.60, 8.08, and 113.1 vs. 0.76, 12.58, and 100.8, respectively). The wild species revealed higher α-tocopherol content (2.40 vs. 1.49 µg/g of fresh meat. Differences observed on their mineral composition counterbalance each other. Under intensive production system and similar feeding and management conditions, the CQ develops better nutritional qualities than JQ. The comparison of wild and farmed species within CQ reveals more similarities than differences. Quail´s meat presents good nutritional quality and introduces variability to human's diet, which is much valued by consumers.
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Affiliation(s)
- M A G Quaresma
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon (FMV/ULisboa), Lisbon, 1300-477 Portugal.
| | - I C Antunes
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon (FMV/ULisboa), Lisbon, 1300-477 Portugal
| | - B Gil Ferreira
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon (FMV/ULisboa), Lisbon, 1300-477 Portugal; LEAF - Linking Landscape, Environment, Agriculture and Food, Institute of Agronomy, University of Lisbon, Lisbon, 1349-017 Portugal
| | - A Parada
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon (FMV/ULisboa), Lisbon, 1300-477 Portugal
| | - A Elias
- LEAF - Linking Landscape, Environment, Agriculture and Food, Institute of Agronomy, University of Lisbon, Lisbon, 1349-017 Portugal
| | - M Barros
- INTERAVES - Sociedade Agro-Pecuária, Abrigada, 2580-067 Portugal
| | - C Santos
- Food Technology and Safety Division, National Institute for Agricultural and Veterinary Research (INIAV, IP), Oeiras, Portugal
| | - A Partidário
- Food Technology and Safety Division, National Institute for Agricultural and Veterinary Research (INIAV, IP), Oeiras, Portugal
| | - M Mourato
- LEAF - Linking Landscape, Environment, Agriculture and Food, Institute of Agronomy, University of Lisbon, Lisbon, 1349-017 Portugal
| | - L C Roseiro
- Food Technology and Safety Division, National Institute for Agricultural and Veterinary Research (INIAV, IP), Oeiras, Portugal
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Louvion E, Santos C, Samuel D. Rehabilitation after proximal interphalangeal joint replacement: A structured review of the literature. Hand Surg Rehabil 2021; 41:14-21. [PMID: 34619399 DOI: 10.1016/j.hansur.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/07/2021] [Accepted: 09/14/2021] [Indexed: 11/29/2022]
Abstract
Proximal interphalangeal (PIP) joint arthroplasty is an unsolved biomechanical challenge despite advances in materials and new implant designs. This leads to a high rate of complications. Moreover, there is heterogeneity in postoperative management according to the literature. The present structured review examined the therapeutic strategies utilized by physiotherapists to restore a functional finger chain and prevent postoperative complications following PIP joint replacement. Patients undergoing primary total PIP joint arthroplasty of the index, ring, middle or little finger were included. Articles published from 2008 onwards, in French or English, and reporting on PIP joint replacement and postoperative management, were included. Therapeutic strategies were organized according to the surgical approach. Details of splint strategies, mobilization and muscle strengthening and management of postoperative complications were collected. Forty-eight studies, 3 of which provided a description of surgical techniques, were included. In relation to hand function, most authors advocated joint mobilization (n = 45) and some recommended muscle strengthening (n = 4). Static (n = 43) and dynamic splints (n = 14) and buddy taping (n = 12) were frequently recommended to prevent and manage postoperative complications. Few studies (n = 13) reported wound assessment or control of postoperative edema. Precise recommendations concerning therapeutic strategies following PIP joint arthroplasty cannot be made based on available evidence. Specific protocols for rehabilitation following PIP joint replacement need to be clarified in future research.
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Affiliation(s)
- E Louvion
- Institut de formation en Masso-Kinésithérapie de Dijon, 6 Bis Rue de Cromois, 21000 Dijon, France.
| | - C Santos
- Institut de formation en Masso-Kinésithérapie de Dijon, 6 Bis Rue de Cromois, 21000 Dijon, France.
| | - D Samuel
- Faculty of Environmental and Life Sciences, University of Southampton, Southampton SO17 1BJ, United Kingdom.
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Tulinius M, Buccella F, Desguerre I, Kirschner J, Mercuri E, Muntoni F, Osorio AN, Johnson S, Werner C, Kristensen A, Jiang J, Li J, Trifillis P, Santos C, McDonald C. DMD - TREATMENT. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mercuri E, Muntoni F, Buccella F, Desguerre I, Kirschner J, Osorio AN, Tulinius M, Johnson S, Werner C, Kristensen A, Jiang J, Li J, Trifillis P, Santos C, McDonald C. DMD - TREATMENT. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Turato E, Santos C, Rodrigues J, Bispo A, Lima C. The practice of sedation in palliative care for oncologic patients: Fantasies reported by a nursing team in a specialized hospital in Brazil: A qualitative study. Eur Psychiatry 2021. [PMCID: PMC9480375 DOI: 10.1192/j.eurpsy.2021.1977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction CONTEXTUALIZATION: Palliative sedation is a resource used to control symptoms of terminal patients in general. It is considered that it should be discussed by the professionals involved in the process, based on the competence of each one, as well as with family members and patients when possible. Objectives AIM: To understand symbolic meanings attributed by nursing professionals who provide assistance to the terminal patient regarding to the act of the palliative sedation. Methods Strategies: Clinical-qualitative design, semi-directed interview of open questions in depth. Nine oncologist nurses participated in the study; sample closed by the criterion of theoretical information saturation. Interviews were audio recorded, transcribed fully, categorized by qualitative content analysis. The results were discussed by colleagues of the Laboratory of Clinical Qualitative Research at the University of Campinas. Results FINDINGS: The treatment of the data led to 6 emerging categories: (1) death maintains its ambivalent values in our culture; (2) serving the death symbolically on a tray; (3) the act of sedation and its “unfortunate coincidences”; (4) palliative sedation: agent of a pious death; (5) late sedation: cause for distress to the professional; (6) the professional’s self-comfort considering certain psychological strength from the patient and family. Conclusions Final considerations: palliative sedation takes a general and individual meanings for the professional and even in case of experienced professionals regard to palliative sedation, the death phenomenon conduct them to expresses multiple and peculiar emotional issues, not ever perceveid. Disclosure No significant relationships.
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Turato E, Bispo A, Rodrigues J, Santos C, Lima C. Implementation of balint group for a team who care patients with head and neck cancer in a service in Brazil: A proposal post qualitative research. Eur Psychiatry 2021. [PMCID: PMC9480131 DOI: 10.1192/j.eurpsy.2021.1723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction The Balint group emerged at the Tavistock Clinic in London in the early 1950s. Its creator was a doctor and psychoanalyst Michael Balint. It consisted of a group process, with meetings among general practitioners, in which non-conscious aspects of the professional-patient relationship were approached. We present how a proposal for implementation of a Balint Group has emerged, specifically for physicians and nurses who care for cancer patients. Is is a consequence of results obtained from a qualitative study conducted by a student of the professional master’s degree linked to a Clinical Oncology. Objectives To present a technical product, as required in a Brazilian professional master’s degree, as a result of research that studied reports of doctors and nurses who deal with usual difficulties of handling patients with HNC. Methods The group work is triggered by the report of a case brought by a participant, presenting a problem-situation in the management of his patient. The meeting leader seeks to understand the reactions reported by the presenter in the light of a psychodynamic approach. Results Expected results: the holding of a Balint group, perhaps monthly, in charge of a colleague who has knowledge in applied psychoanalysis, will allow insights to the participants who will bring them conditions to perceive “neurotic elements” in the relationship with their patient. Conclusions Final consideration: having accumulated decades of positive experience, Balint Groups must remain as an updated proposal for the work on emotional issues of professional teams, with emphasis on clinical services with the management of so-called “difficult patients”. Disclosure No significant relationships.
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Quintão A, Santos C, Urzal M, Donas-Boto I, Azevedo F, Lemos M, Coelho F, Vian J. Why does transcultural consultation matter? Eur Psychiatry 2021. [PMCID: PMC9480339 DOI: 10.1192/j.eurpsy.2021.1812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction Psychiatrists should be aware of the new challenges and needs that globalization poses. Objectives To highlight the need for a culturally sensitive approach to mental health. Methods Non-systematic review of “cultural consultation” on PubMed. Results Most people assume a direct connection between pathophysiology and clinical symptoms. However, evidence shows that the translation of pathophysiology and psychopathology into specific symptoms is mediated by cognitive processes and social interactions, which reflect models/practices specific to our culture. Patients focus on specific aspects of being sick, reinforced by cultural narratives or to fit expectations. Thus, people from different cultural backgrounds might have trouble communicating; cultural idioms of distress can be misinterpreted. The role of structural violence bestowed upon cultural minorities, which leads to discrimination and social exclusion, has extensively been studied as a risk factor for mental illness. Furthermore, ignoring cultural differences and diversity has been shown to contribute to healthcare disparities, hampering access to care and diminishing the quality of care received. In Canada, the Cultural Consultation Model provides cultural expertise, either by evaluating patients (preferably accompanied by the referring doctor, a translator and cultural mediator) for 1-3 sessions, providing recommendations to the referring doctor; or providing consulting to a referring doctor or organisation, through general guidance or discussion of specific cases. Conclusions In an evergrowing globalization process, we will inevitably have more contact with patients from culturally distinct backgrounds. To provide the best care, we must be aware of the ways in which culture can shape symptom expression, and take into account cultural explanations and preferences. Disclosure No significant relationships.
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Andrade F, Guedes R, Santos C. Dementia and suicide: What relationship to establish and what risks to consider? Eur Psychiatry 2021. [PMCID: PMC9475794 DOI: 10.1192/j.eurpsy.2021.1130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction Given the marked population aging in the world, the incidence of dementia has significantly increased, becoming a growing health care problem. Suicide is a considerable health issue throughout the life span, being prevalent in older adults, and in many countries the highest suicide rates are found in the elderly. Thus far, the relationship between dementia and suicide remains poorly understood and inconsistent. Objectives The aim of this study is to do a non-systematic review of the current literature regarding the association between suicide risk and dementia. Methods We conducted a research using the Medline database, through the Pubmed search engine, using the following key-words: “dementia”, “suicide” and “risk factors”. Results Overall, the risk of suicide in people with dementia appears to be the same as that of age-matched general population. However, studies point to the existence of a number of factors that can increase this risk, such as: early age of dementia diagnosis, recent diagnosis, disease awareness and depression, hopelessness, male gender, failure to respond to anti-dementia medication, history of inpatient psychiatric hospitalizations, concurrent medical comorbidities. Conclusions Studies have reported mixed results as to whether dementia itself is an independent risk factor for suicide. Despite these findings, understanding the risk factors for suicide among people with dementia is crucial and suicide prevention efforts should be carried out in this population.
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Gomes R, Santos C, Moutinho F. What is the best approach for patients with prolonged duration of untreated psychosis (DUP) - about 2 clinical cases with dup longer than 10 years. Eur Psychiatry 2021. [PMCID: PMC9476101 DOI: 10.1192/j.eurpsy.2021.1443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionStudies have consistently found that many individuals with psychosis experience significant delays before receiving treatment. DUP refers to the period between the emergence of psychotic symptoms and the initiation of appropriate clinical treatment.ObjectivesTo review current knowledge on the best approach for patients with schizophrenia (SCZ) and prolonged DUP.MethodsNon-systematic review of literature through search on PubMed database, following the terms “DUP and treatment” and “impact of longer DUP”. Two clinical cases are described.ResultsThe clinical cases describe patients with SCZ with DUPs older than 10 years, in whom we could not achieve complete clinical remission after several therapeutic trials and whose prognosis was admitted as reserved. Longer DUP is an independent predictor of poorer outcome in SCZ, including the poor response to treatment and difficulty in achieving remission, predicting treatment resistance. Identifying treatment-resistant patients is crucial due to the importance of initiating clozapine as early as possible since the chances of responding are higher.ConclusionsDUP is a key prognostic variable in psychosis, revealing the significance of early treatment. Patients with long DUP should be regarded as at high risk of poor recovery. The detection of these patients enables clinicians to avoid unnecessary exposure to ineffective treatments while effective interventions are delayed. However, in view of adverse side effects of clozapine, future studies need to examine relevant predictors to detect accurately non-responders. We also suggest further studies to understand if there is correspondence between DUP and different stages of the disease that justify these results.
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Khan SF, Martinez DA, Kalantar DH, Kirkwood RK, Santos C, Ose NA, Johnson S, Alessi DA, Prantil MA, Woods DT, Glendinning SG, Tommasini R, Mackinnon AJ, Prisbrey ST, Dittrich TR, Bowers MW, Cabral J, Crane J, Di Nicola JM, Hamamoto M, Herriot S, Lanier T, Lowe-Webb R, Pelz LJ, Widmayer CC, Williams W, Yang S. A dual high-energy radiography platform with 15 μm resolution at the National Ignition Facility. Rev Sci Instrum 2021; 92:043712. [PMID: 34243490 DOI: 10.1063/5.0044043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/22/2021] [Indexed: 06/13/2023]
Abstract
To study matter at extreme densities and pressures, we need mega laser facilities such as the National Ignition Facility as well as creative methods to make observations during timescales of a billionth of a second. To facilitate this, we developed a platform and diagnostic to characterize a new point-projection radiography configuration using two micro-wires irradiated by a short pulse laser system that provides a large field of view with up to 3.6 ns separation between images. We used tungsten-carbide solid spheres as reference objects and inferred characteristics of the back-lighter source using a forward-fitting algorithm. The resolution of the system is inferred to be 15 μm (using 12.5 μm diameter wires). The bremsstrahlung temperature of the source is 70-300 keV, depending on laser energy and coupling efficiency. By adding the images recorded on multiple stacked image plates, the signal-to-noise of the system is nearly doubled. The imaging characterization technique described here can be adapted to most point-projection platforms where the resolution, spectral contrast, and signal-to-noise are important.
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Affiliation(s)
- S F Khan
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D A Martinez
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D H Kalantar
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R K Kirkwood
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - C Santos
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - N A Ose
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S Johnson
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D A Alessi
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - M A Prantil
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D T Woods
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S G Glendinning
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R Tommasini
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - A J Mackinnon
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S T Prisbrey
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - T R Dittrich
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - M W Bowers
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Cabral
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Crane
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J-M Di Nicola
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - M Hamamoto
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S Herriot
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - T Lanier
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R Lowe-Webb
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - L J Pelz
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - C C Widmayer
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - W Williams
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S Yang
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
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Lee JH, Yum HK, Jamous F, Santos C, Campisi A, Surani S, Lococo F, Goo JM, Yoon SH. Diagnostic procedures and clinico-radiological findings of acute fibrinous and organizing pneumonia: a systematic review and pooled analysis. Eur Radiol 2021; 31:7283-7294. [PMID: 33791819 DOI: 10.1007/s00330-021-07868-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 01/12/2021] [Accepted: 03/11/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To evaluate the clinico-radiological findings of acute fibrinous and organizing pneumonia (AFOP) in the literature according to whether a surgical or non-surgical biopsy was performed, as well as to identify prognostic predictors. METHODS We searched the Embase and OVID-MEDLINE databases to identify studies that presented CT findings of AFOP and had extractable individual patient data. We compared the clinical and CT findings of the patients depending on whether a surgical or non-surgical biopsy was performed and identified survival predictors using a multivariate logistic regression analysis. RESULTS Eighty-one patients (surgical biopsy, n = 52; non-surgical biopsy, n = 29) from 63 studies were included. The surgical biopsy group frequently experienced an acute fulminant presentation (p = .011) and dyspnea (p = .001) and less frequently had a fever (p = .006) than the non-surgical biopsy group. The surgical biopsy group had a worse prognosis than the non-surgical biopsy group in terms of mechanical ventilation and mortality (both, p = .023). For survival analysis, the patients with the predominant CT finding of patchy or mass-like air-space consolidation survived more frequently (p < .001) than those with other CT findings. For prognostic predictors, subacute indolent presentation (p = .001) and patchy or mass-like air-space consolidation on CT images (p = .002) were independently associated with good survival. CONCLUSIONS Approximately one-third of alleged AFOP cases in the literature were diagnosed via non-surgical biopsy, but those cases had different symptomatic presentations and prognosis from surgically proven AFOP. Subacute indolent presentation and patchy or mass-like air-space consolidation at the presentation on CT images indicated a good prognosis in patients with AFOP. KEY POINTS • Acute fibrinous and organizing pneumonia (AFOP) cases diagnosed via non-surgical biopsy had different symptomatic presentations and prognosis from surgically proven AFOP. • Subacute indolent presentation and patchy or mass-like air-space consolidation on CT images indicated a good prognosis in patients with acute fibrinous and organizing pneumonia.
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Affiliation(s)
- Jong Hyuk Lee
- Department of Radiology, Seoul National University Hospital, Seoul National College of Medicine, Seoul, South Korea
| | - Ho-Kee Yum
- Department of Internal Medicine, Seoul Paik Hospital, Inje University, Seoul, South Korea
| | - Fady Jamous
- Department of Pulmonary & Sleep Medicine, Avera Medical Group, Sioux Falls, SD, USA
| | - Cláudia Santos
- Pulmonology Service, Centro Hospitalar de Leiria, Leiria, Portugal
| | - Alessio Campisi
- Thoracic Surgery Unit, Department of Thoracic Diseases, University of Bologna, G.B. Morgagni-L. Pierantoni Hospital, 34 Carlo Forlanini Street, 47121, Forlì, Italy
| | - Salim Surani
- Department of Medicine, University of North Texas, Denton, TX, USA.,Department of Medicine, Texas A&M University, Corpus Christi, TX, USA
| | - Filippo Lococo
- Department of Translational Medicine and Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Unit of Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Jin Mo Goo
- Department of Radiology, Seoul National University Hospital, Seoul National College of Medicine, Seoul, South Korea
| | - Soon Ho Yoon
- Department of Radiology, Seoul National University Hospital, Seoul National College of Medicine, Seoul, South Korea.
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Francisco M, Costa B, Almeida B, Santos C, Casaes A, Dos Santos Y, Fialho T, Dos Santos R, Macedo M, Oliveira R, Siqueira I. Seroprevalence of Zika, Chikungunya and Dengue viruses in a rural area of northeastern Brazil. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.11.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Quintela C, Santos C, Silva AC, Barbosa E, Silva AR, Silva A. Colo-ovarian Fistula complicating acute diverticulitis: Two cases and literature review. Int J Surg Case Rep 2020; 77:476-482. [PMID: 33395829 PMCID: PMC7701013 DOI: 10.1016/j.ijscr.2020.10.144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 10/31/2020] [Accepted: 10/31/2020] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Colonic diverticulosis is common in western world. Fistula formation occurs in 10-20 % of patients, usually as a consequence of an acute inflammatory process (diverticulitis). Fistulas from diverticulitis occur mainly to bladder, small bowel and uterus. Communication between colon and ovary occurred more frequently in the context of primary neoplasms of ovary, ovarian abscess or Crohn's disease. However, colo-ovarian fistula after acute colonic diverticulitis is a rare entity with few cases reported in literature. PRESENTATION OF CASES In this article, we described two cases. We also performed a literature review. In both cases, an initial conservative management for acute diverticulitis was performed. The maintenance of symptoms dictated further investigation. The presence of left ovarian abscess was presented, suggesting the presence of fistula. DISCUSSION Although the distinct evolution during the initial treatment, which results in different timing for surgery, en bloc resection of colon and adnexa was performed, with favorable outcomes. Final pathological analysis confirmed the diagnosis. CONCLUSION Colo-ovarian fistulas complicating acute diverticulitis are rare entities. In this article, we present our experience in the management of two cases, with different surgical approach but favorable outcomes.
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Affiliation(s)
- Catarina Quintela
- Hospital Pedro Hispano - Department of Surgery, Matosinhos. R. de Dr. Eduardo Torres, Sra. da Hora, Matosinhos, Portugal.
| | - Cláudia Santos
- Hospital Pedro Hispano - Department of Surgery: Colo-rectal Surgery, Matosinhos, Portugal.
| | | | - Eva Barbosa
- Hospital Pedro Hispano - Department of Surgery: Colo-rectal and Abdominal Wall Surgery, Matosinhos, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal.
| | | | - Artur Silva
- Hospital Pedro Hispano - Department of Pathology, Matosinhos, Portugal.
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Muntoni F, Mercuri E, Buccella F, Desguerre I, Kirschner J, Osorio AN, Tulinius M, Jiang J, Kristensen A, Johnson S, Able R, Trifillis P, Santos C. DMD & BMD – CLINICAL. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Vaz Pinto I, Guimaraes M, Castro V, Santos C, Galiano A, Friaes J, Bile A, Casqueira A. Automated HIV screening in the emergency department –earlier diagnosis, improved clinical outcomes. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
HIV/AIDS is a public health problem worldwide because undiagnosed patients maintain onward transmission. To stop viral transmission an upscale in diagnostics is needed so that more patients start treatment; patients on treatment and with undetectable viral load do not transmit the virus to other persons (“Treatment as Prevention”).
Objectives
We aimed at identifying more HIV infections in the emergency Department (ED) and at doing so earlier in the course of disease.
Methods
we designed an automated and clinician independent HIV screening project in the ED. Electronic Medical Record (EMR) automatically generates a request for HIV antibody (HIV Ab) test when a patient: a) is 18-65 years of age and has a request for any blood test; b) is not identified in the EMR as being HIV infected; c) does not have an HIV Ab in the EMR in the previous year. Nursing staff receive a visual warning of patients' eligibility for screening and an extra tube label is printed out for HIV testing. The patient is informed of screening at the moment of blood drawing and an <<opt-out >> strategy is applied (optional verbal informed consent or <<opt-out >> of screening).
Results
In 16 months, a total of 21.487 people were eligible for screening. 18.072 HIV Ab screening tests were done. The opt-out rate was 6.3% and there were 44 new HIV diagnostics (prevalence rate 0.24%). Late presenting patients (baseline CD4 counts <350) dropped from an average of 56% in the previous 6 years at our institution to 36.3%. Median CD4 count at diagnostics went up from 192 to 388 cells/mm³.
Conclusions
An automated and clinician independent HIV screening program in the ED proved to be successful at identifying more HIV patients and at tackling the problem of late presentation. Diagnosing early in the course of infection is beneficial for the individual patient, but also represents a gain in general public health because onward transmission is stopped by starting antiretroviral treatment.
Key messages
Early diagnosis through universal screening. Treatment as prevention.
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Affiliation(s)
- I Vaz Pinto
- HIV Unit, Hospital de Cascais, Alcabideche, Portugal
| | - M Guimaraes
- HIV Unit, Hospital de Cascais, Alcabideche, Portugal
| | - V Castro
- HIV Unit, Hospital de Cascais, Alcabideche, Portugal
| | - C Santos
- HIV Unit, Hospital de Cascais, Alcabideche, Portugal
| | - A Galiano
- Emergency Department, Hospital de Cascais, Alcabideche, Portugal
| | - J Friaes
- Emergency Department, Hospital de Cascais, Alcabideche, Portugal
| | - A Bile
- Project and Continuos Improvement Department, Hospital de Cascais, Alcabideche, Portugal
| | - A Casqueira
- Project and Continuos Improvement Department, Hospital de Cascais, Alcabideche, Portugal
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Terras Marques I, Santos C, Santos V. Process modelling of organized screening programs – breast cancer. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Breast cancer is the most frequent cancer among women and one of the principal causes of cancer related death in women worldwide, being a public health problem. Oncology screenings allow its early detection and reduce its mortality. Business process management (BPM) is a management field that leads an organization into continuously improvement with increase of efficiency. The processes of the healthcare system are complex what makes the application of BPM techniques harder, however their usage has been increasing in this sector.
The main objective of this study is the identification and modelling of BPM processes for the Portuguese breast cancer screening.
The current processes and the entities (actors, systems and documents) involved in the Breast Cancer Organized Screening performed by the Portuguese League Against Cancer were identified through interviews to the employees. With the information retrieved and using Bizagi the related As-Is diagrams were developed.
In this work 5 processes within the Breast Cancer Organized Screening were identified: Process “Patients' invitation”; Process “Screening”; Process “Reading of the exam”; Process “Check-up Consultation” and Process “Sending Results”. Through the analysis of the As-Is diagrams and of the available information, a critical analysis was made. As for example, in the process “Patients' invitation” an invitation letter is sent 15 days earlier to the patient but no telephone contact is done before the screening. An improvement could be sending a message in the day before the screening, remembering the appointment, avoiding forgetfulness absences.
With this work the mainly processes of the breast cancer organized screening were modelled as “As-Is” diagrams and, in a macroscopic way, some of the problems were identified and improvement suggestions were made in order to achieve the main objective of the process, the early detection of breast cancer, while optimizing the process.
Key messages
This work represents an important contribution to the Breast Cancer Organized Screening since, through the use of BPM, a set of actions is proposed with an impact on its effectiveness and efficiency. This work represents an example of what the BPM techniques can do to help in the optimization of all the processes of the healthcare sector, from screening to diagnosis and treatment.
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Affiliation(s)
- I Terras Marques
- Nova Information Management School, NOVA University of Lisbon, Lisbon, Portugal
| | - C Santos
- National School of Public Health, Public Health Research Centre, NOVA University of Lisbon, Lisbon, Portugal
| | - V Santos
- Nova Information Management School, NOVA University of Lisbon, Lisbon, Portugal
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Moraes MM, Oliveira B, Afonso C, Santos C, Miranda RC, Rauber F, Levy RB, Rodrigues S. Mediterranean diet, sociodemographic factors and ultra-processed food consumption in Portugal. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Mediterranean diet has been shown to promote beneficial effects on health, while ultra-processed food (UPF) consumption has been associated with lower diet quality and higher risk for non-communicable diseases. Our aims were to explore the adherence to a Mediterranean dietary pattern (MDP) in Portugal and its association with sociodemographic factors and UPF consumption.
Methods
Participants were from the Portuguese National Food, Nutrition and Physical Activity Survey 2015-2016, aged 18-84y (n = 3,852). CAPI face-to-face interviews were used including 2 dietary 24-h recalls. UPF were identified using NOVA classification. Adherence to MDP was defined by the Mediterranean Diet Score (MDS), which may vary from 0 to 9. MDS≥6 was considered as high adherence. Weighted multivariate logistic regression analysis was used to explore associations of high adherence to MDP with sex, age, region, educational level, family income and dietary share of UPF groups.
Results
High adherence to MDP was observed for 19.6% of participants and was inversely associated with higher consumption of UPF, namely, sugar-sweetened beverages (OR = 0.924; 95%CI 0.883-0.966), confectionery (OR = 0.893; 95%CI 0.816-0.977), sweet snacks (OR = 0.953; 95%CI 0.923-0.985), cakes/desserts (OR = 0.956; 95%CI 0.934-0.978) and meat products (OR = 0.922; 95%CI 0.874-0.972). Being female (OR = 0.629; 95%CI 0.471-0.841) and not from the North or Alentejo regions were inversely associated with high adherence to MDP. There was no relation between income and adherence to MDP. The higher the level of education or age, the higher the odds of high adherence to MDP (OR = 2.573; 95%CI 1.741-3.803 and OR = 1.028; 95%CI 1.020-1.037, respectively).
Conclusions
Actions to improve adherence to MDP in Portugal should consider discouraging UPF consumption and be addressed to specific subgroups.
Funding
POCI-01-0145-FEDER-032090 (FCT/FEDER); FAPESP 2018/07391-9, 2019/05972-7 (MCR), 2016/14302-7 (FR).
Key messages
High adherence to a Mediterranean dietary pattern was observed for near 20% of Potuguese over 18 years old. The higher the level of education or age, the higher the odds of high adherence to MDP. High adherence to a Mediterranean dietary pattern was inversely associated with higher consumption of sugar-sweetened beverages, confectionery, sweet snacks, cakes/desserts and meat products.
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Affiliation(s)
- M M Moraes
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - B Oliveira
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- Laboratório de Inteligência Artificial e Apoio à Decisão, Instituto de Engenharia de Sistemas e Computadores, Tecnologia e Ciência, Porto, Portugal
| | - C Afonso
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - C Santos
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - R C Miranda
- Department of Preventative Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - F Rauber
- Department of Preventative Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - R B Levy
- Department of Preventative Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - S Rodrigues
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
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Margalef NM, Castillo C, Mosteiro M, Martinez JP, PAdrol I, Aguilar S, Villacampa MM, Rodriguez JR, Losa F, Vega AT, Soler G, Castany R, Capdevila F, Gil-Martin M, Cuadra C, Elez E, Garralda E, Salazar R, Dienstmann R, Santos C. 477P Genomically-matched therapy in refractory CRC according to ESCAT. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Soler G, Legido R, Perez X, Martinez-Villacampa M, Santos C, Losa F, Ruffinelli J, Mulet N, Teule A, Castany R, Gallego R, Carbonell M, Manzana A, Rios A, Saldaña J, Salazar R. 513P Prospective evaluation of the G8 screening tool for predicting survival in elderly patients with colon cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Santos C, Imteaz MA, Ghisi E, Matos C. The effect of climate change on domestic Rainwater Harvesting. Sci Total Environ 2020; 729:138967. [PMID: 32387776 DOI: 10.1016/j.scitotenv.2020.138967] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 04/22/2020] [Accepted: 04/22/2020] [Indexed: 06/11/2023]
Abstract
One of the main strategies that are being applied to improve the efficiency of water consumption in buildings is the use of non-potable water for pavement washing, toilet flushing, irrigation, and others. According to several guidelines, the design and assessment of a Rainwater Harvesting System (RWHS) should be made using recent official records of precipitation. However, there is not an indication whether historical or future projections should be used, leaving space for the designer to choose. This article presents the study of RWHS in southern Europe, namely in Portugal, considering two case studies (a dwelling in Oporto and an apartment in Vila Real). The main goal was to explore the impacts that climate change will have on these systems and, for that purpose, a daily simulation using future rainfall data was performed for both cases considering two scenarios: RCP 4.5 which is more optimistic, and RCP 8.5 which is more pessimistic. The RWHS in Oporto showed a better performance in the future decades, comparing with simulations based on recent decades, for both scenarios. However, the savings will not have a significant variation (less than 5 €/year). In the future, this system will provide around 47 (±2.4) m3 of rainwater per year to the selected non-potable purposes, leading to savings of around 66 (±3.3) €/year. Vila Real case study also revealed a slight improvement of the system's efficiency in the future decades but the results for rainwater collected and used are so similar to the recent ones that it can be concluded that the performance will be sustained. This system will provide around 50 (±2.5) m3 of rainwater per year to the selected non-potable purposes, leading to savings of around 200 (±10.2) €/year. It can be concluded that there will be no significant changes in RWHS performance in the future, in the studied areas.
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Affiliation(s)
- C Santos
- Faculty of Engineering, Porto University, Portugal.
| | - M A Imteaz
- Department of Civil & Construction Engineering, Swinburne University of Technology, Hawthorn VIC3122, Australia
| | - E Ghisi
- Federal University of Santa Catarina, Department of Civil Engineering, Florianópolis, SC, Brazil
| | - C Matos
- ECT-School of Science and Technology, University of Trás-os-Montes e Alto Douro UTAD, Quinta de Prados, 5000-801 Vila Real, Portugal; C-MADE - Centre of Materials and Building Technologies, University of Beira Interior, 6201-001 Covilhã, Portugal
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Rocha G, de Lima FF, Machado AP, Guimarães H, Proença E, Carvalho C, Martins LG, Martins T, Freitas A, Dias CP, Silva A, Barroso A, Diogo I, Cassiano G, Ramos H, Abrantes MM, Costa P, Salazar A, Vieira F, Fontes D, Barroso R, Marques T, Santos V, Scortenschi E, Santos C, Vilela F, Quintas C. Small for gestational age very preterm infants present a higher risk of developing bronchopulmonary dysplasia. J Neonatal Perinatal Med 2020; 12:419-427. [PMID: 31256077 DOI: 10.3233/npm-180129] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Several studies assessed the influence of a low birth weight on bronchopulmonary dysplasia (BPD), but not all could find a significant association. Our aim was to assess the association between low birth weight and BPD in preterm infants, prospectively recruited at 11 level III Portuguese neonatal centers. METHODS Obstetrical and neonatal data on mothers and preterm infants with gestational ages between 24 and 30 weeks, born during 2015 and 2016 after a surveilled pregnancy, were analyzed. Neonates were considered small for gestational age (SGA) when their birthweight was below the 10th centile of Fenton's growth chats and BPD was defined as the dependency for oxygen therapy until 36 weeks of corrected age. Statistical analysis was performed using IBM SPSS® statistics 23 and a p-value <0.05 was considered statistically significant. RESULTS Out of 614, a total of 494 preterm infants delivered from 410 women were enrolled in the study; 40 (8.0%) infants with SGA criteria. SGA were more often associated with a single pregnancy, had greater use of antenatal corticosteroids, increased prevalence of gestational hypertensive disorders, C-section, rupture of membranes below 18 hours, rate of intubation in the delivery room, use of surfactant treatment, oxygen therapy, mechanical ventilation need, BPD, cystic periventricular leukomalacia, nosocomial sepsis and pneumonia; had lower prevalence of chorioamnionitis, and lower Apgar scores. The multivariate analysis by logistic regression, adjusted for BPD risk factors revealed a significant association between SGA and BPD: OR = 5.2 [CI: 1.46-18.58]; p = 0.01. CONCLUSION The results of this study increase the scientific evidence that SGA is an independent risk factor for BPD.
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Affiliation(s)
- G Rocha
- Department of Neonatology, Centro Hospitalar São João, Porto, Portugal
| | - F Flor de Lima
- Department of Neonatology, Centro Hospitalar São João, Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal
| | - A Paula Machado
- Department of Obstetrics and Gynaecology, Centro Hospitalar São João, Porto, Portugal
| | - H Guimarães
- Department of Neonatology, Centro Hospitalar São João, Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal
| | - E Proença
- Centro Materno Infantil do Norte, Porto, Portugal
| | - C Carvalho
- Centro Materno Infantil do Norte, Porto, Portugal
| | - L G Martins
- Centro Materno Infantil do Norte, Porto, Portugal
| | - T Martins
- Hospital Pedro Hispâno, Matosinhos, Portugal
| | - A Freitas
- Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - C P Dias
- Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - A Silva
- Hospital de Braga, Braga, Portugal
| | | | - I Diogo
- Centro Hospitalar Lisboa Central, Maternidade Dr Alfredo da Costa, Lisboa, Portugal
| | - G Cassiano
- Centro Hospitalar Lisboa Central, Maternidade Dr Alfredo da Costa, Lisboa, Portugal
| | - H Ramos
- Centro Hospitalar Lisboa Central, Maternidade Dr Alfredo da Costa, Lisboa, Portugal
| | - M M Abrantes
- Centro Hospitalar Lisboa Norte, Hospital de Santa Maria, Lisboa, Portugal
| | - P Costa
- Centro Hospitalar Lisboa Norte, Hospital de Santa Maria, Lisboa, Portugal
| | - A Salazar
- Centro Hospitalar Lisboa Ocidental, Hospital São Francisco Xavier, Lisboa, Portugal
| | - F Vieira
- Centro Hospitalar Lisboa Ocidental, Hospital São Francisco Xavier, Lisboa, Portugal
| | - D Fontes
- Centro Hospitalar Lisboa Ocidental, Hospital São Francisco Xavier, Lisboa, Portugal
| | - R Barroso
- Hospital Prof. Dr Fernando Fonseca, Amadora, Portugal
| | - T Marques
- Hospital Prof. Dr Fernando Fonseca, Amadora, Portugal
| | - V Santos
- Centro Hospitalar do Algarve, Hospital de Faro, Faro, Portugal
| | - E Scortenschi
- Centro Hospitalar do Algarve, Hospital de Faro, Faro, Portugal
| | - C Santos
- Centro Hospitalar do Algarve, Hospital de Faro, Faro, Portugal
| | - F Vilela
- Centro Hospitalar do Algarve, Hospital de Faro, Faro, Portugal
| | - C Quintas
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Hospital de Vila Nova de Gaia, Vila Nova de Gaia, Portugal
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Santos C, Dixe MA, Sacadura-Leite E, Astoul P, Sousa-Uva A. Asbestos Exposure and Malignant Pleural Mesothelioma in Portugal: a scoping review. Eur J Public Health 2020. [DOI: https://doi.org/10.1093/eurpub/ckaa040.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Abstract
Introduction Asbestos, widely used for its important chemical and physical characteristics, are recognized in all their varieties as a human carcinogen by the International Agency for Research on Cancer (IARC) and as the leading cause of cancer associated with occupational exposure in industrialized countries. Despite being the most studied occupational hazard since 1965, it is the malignant pleural mesothelioma (MPM), the decisive aspect in the study of the exposure to asbestos.
Objectives Make a state of the art of the relationships between asbestos and MPM in Portugal.
Methodology A scoping review using the Joanna Briggs Institute (JBI) methodology was conducted using five information’s sources: Pubmed, Web of Science, The Cochrane Library, Scopus and Google Scholar and Open Access Scientific Repositories of Portugal and DART-Europe E-theses Portal to search also for gray literature. Data were collected between 1960-2019, with the keywords "Asbestos" and "Mesothelioma” and “Portugal”. Inclusion criteria were defined for types of participants, concept, context and types of studies.
Results Of the 1453 studies reviewed 9 were included. The oldest study is from 1986. Five studies are about incidence and survival, two are case reports, one about exposure and mortality and one about treatment. To analyse incidence and mortality, four authors used hospital data and two the data from the southern regional cancer registry (ROR). In these studies, it is also presented the description of the population in terms of mean age, type of exposure, latency time, histological type and stage.
Conclusion Portugal, such as other industrialized countries, used asbestos in a massive way, but despite this, few studies and data on the relationship between asbestos exposure and MPM are found. Dedicated studies are needed to objectively assess the true dimension of this potential problem in Portugal and characterise the different types of exposures related to MPM.
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Affiliation(s)
- C Santos
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa; Centro Hospitalar de Leiria, Portugal
| | - MA Dixe
- Instituto Politécnico de Leiria; ciTechCare, Portugal
| | - E Sacadura-Leite
- Departamento de Saúde Ocupacional e Ambiental da Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa; CISP - Centro de Investigação em Saúde Pública; Serviço de Saúde Ocupacional do CHLN, Portugal
| | - P Astoul
- Department of Thoracic Oncology, Pleural Diseases, and Interventional Pulmonology; Hôpital Nord – Aix-Marseille University, France
| | - A Sousa-Uva
- Coordenador do Departamento de Saúde Ocupacional e Ambiental da Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa; CISP - Centro de Investigação em Saúde Pública, Portugal
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Carvalho Gontijo C, Porras-Hurtado LG, Freire-Aradas A, Fondevila M, Santos C, Salas A, Henao J, Isaza C, Beltrán L, Nogueira Silbiger V, Castillo A, Ibarra A, Moreno Chavez F, Söchtig J, Ruiz Y, Barreto G, Rondon F, Zabala W, Borjas L, de Oliveira SF, Carracedo A, Lareu MV, Phillips C. Corrigendum to "PIMA: A population informative multiplex for the Americas" [Forensic Sci. Int.: Genet. 44 (2020) 102200]. Forensic Sci Int Genet 2020; 48:102320. [PMID: 32574992 DOI: 10.1016/j.fsigen.2020.102320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2020] [Indexed: 11/29/2022]
Affiliation(s)
- C Carvalho Gontijo
- Forensic Genetics Unit, University of Santiago de Compostela, Spain; Human Genetics Laboratory, Institute of Biological Sciences, University of Brasília, Brazil
| | - L G Porras-Hurtado
- Forensic Genetics Unit, University of Santiago de Compostela, Spain; Medical Genetics Laboratory, Human Molecular Genetics Research Group, Technology University of Pereira, Colombia
| | - A Freire-Aradas
- Forensic Genetics Unit, University of Santiago de Compostela, Spain
| | - M Fondevila
- Forensic Genetics Unit, University of Santiago de Compostela, Spain
| | - C Santos
- Forensic Genetics Unit, University of Santiago de Compostela, Spain
| | - A Salas
- Forensic Genetics Unit, University of Santiago de Compostela, Spain
| | - J Henao
- Medical Genetics Laboratory, Human Molecular Genetics Research Group, Technology University of Pereira, Colombia
| | - C Isaza
- Medical Genetics Laboratory, Human Molecular Genetics Research Group, Technology University of Pereira, Colombia
| | - L Beltrán
- Medical Genetics Laboratory, Human Molecular Genetics Research Group, Technology University of Pereira, Colombia; Health Science Faculty, Unidad Central del Valle del Cauca, Tulua, Colombia
| | - V Nogueira Silbiger
- Department of Clinical and Toxicological Analysis, Health Sciences Center, Federal University of Rio Grande do Norte, Brazil
| | - A Castillo
- Medical Genetic Laboratory, Industrial University of Santander (UIS), Colombia
| | - A Ibarra
- Medical Genetics Laboratory, University of Antioquia, Colombia
| | - F Moreno Chavez
- Servicio Médico Legal, Ministry of Justice and Human Rights of Chile, Santiago, Chile
| | - J Söchtig
- Forensic Genetics Unit, University of Santiago de Compostela, Spain
| | - Y Ruiz
- Forensic Genetics Unit, University of Santiago de Compostela, Spain
| | - G Barreto
- Human Molecular Genetics Research Group, University of Valle, Colombia
| | - F Rondon
- School of Biology, Industrial University of Santander (UIS), Colombia
| | - W Zabala
- Molecular Genetics Laboratory, Medical Genetics Unit, University of Zulia, Venezuela
| | - L Borjas
- Molecular Genetics Laboratory, Medical Genetics Unit, University of Zulia, Venezuela
| | - S F de Oliveira
- Human Genetics Laboratory, Institute of Biological Sciences, University of Brasília, Brazil.
| | - A Carracedo
- Forensic Genetics Unit, University of Santiago de Compostela, Spain; Grupo de Medicina Xenómica, CIBERER, University of Santiago de Compostela, Spain
| | - M V Lareu
- Forensic Genetics Unit, University of Santiago de Compostela, Spain
| | - C Phillips
- Forensic Genetics Unit, University of Santiago de Compostela, Spain.
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Santos C, Dixe MA, Sacadura-Leite E, Astoul P, Sousa-Uva A. Asbestos Exposure and Malignant Pleural Mesothelioma in Portugal: a scoping review. Eur J Public Health 2020. [DOI: https:/doi.org/10.1093/eurpub/ckaa040.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Abstract
Introduction Asbestos, widely used for its important chemical and physical characteristics, are recognized in all their varieties as a human carcinogen by the International Agency for Research on Cancer (IARC) and as the leading cause of cancer associated with occupational exposure in industrialized countries. Despite being the most studied occupational hazard since 1965, it is the malignant pleural mesothelioma (MPM), the decisive aspect in the study of the exposure to asbestos.
Objectives Make a state of the art of the relationships between asbestos and MPM in Portugal.
Methodology A scoping review using the Joanna Briggs Institute (JBI) methodology was conducted using five information’s sources: Pubmed, Web of Science, The Cochrane Library, Scopus and Google Scholar and Open Access Scientific Repositories of Portugal and DART-Europe E-theses Portal to search also for gray literature. Data were collected between 1960-2019, with the keywords "Asbestos" and "Mesothelioma” and “Portugal”. Inclusion criteria were defined for types of participants, concept, context and types of studies.
Results Of the 1453 studies reviewed 9 were included. The oldest study is from 1986. Five studies are about incidence and survival, two are case reports, one about exposure and mortality and one about treatment. To analyse incidence and mortality, four authors used hospital data and two the data from the southern regional cancer registry (ROR). In these studies, it is also presented the description of the population in terms of mean age, type of exposure, latency time, histological type and stage.
Conclusion Portugal, such as other industrialized countries, used asbestos in a massive way, but despite this, few studies and data on the relationship between asbestos exposure and MPM are found. Dedicated studies are needed to objectively assess the true dimension of this potential problem in Portugal and characterise the different types of exposures related to MPM.
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Affiliation(s)
- C Santos
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa; Centro Hospitalar de Leiria, Portugal
| | - MA Dixe
- Instituto Politécnico de Leiria; ciTechCare, Portugal
| | - E Sacadura-Leite
- Departamento de Saúde Ocupacional e Ambiental da Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa; CISP - Centro de Investigação em Saúde Pública; Serviço de Saúde Ocupacional do CHLN, Portugal
| | - P Astoul
- Department of Thoracic Oncology, Pleural Diseases, and Interventional Pulmonology; Hôpital Nord – Aix-Marseille University, France
| | - A Sousa-Uva
- Coordenador do Departamento de Saúde Ocupacional e Ambiental da Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa; CISP - Centro de Investigação em Saúde Pública, Portugal
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Souza J, Araújo B, Leite J, Vasconcelos A, Santos C, Aguiar M, Catai A, Brandão D, De Andrade AD. IS THERE AN ASSOCIATION BETWEEN THE PRESENCE OF ENDOTHELIAL DYSFUNCTION AND EXERCISE TOLERANCE IN CARDIAC TRANSPLANT RECIPIENTS? Chest 2020. [DOI: 10.1016/j.chest.2020.05.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Santos C, Dixe MA, Sacadura-Leite E, Astoul P, Sousa-Uva A. Asbestos Exposure and Malignant Pleural Mesothelioma in Portugal: a scoping review. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa040.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction Asbestos, widely used for its important chemical and physical characteristics, are recognized in all their varieties as a human carcinogen by the International Agency for Research on Cancer (IARC) and as the leading cause of cancer associated with occupational exposure in industrialized countries. Despite being the most studied occupational hazard since 1965, it is the malignant pleural mesothelioma (MPM), the decisive aspect in the study of the exposure to asbestos.
Objectives Make a state of the art of the relationships between asbestos and MPM in Portugal.
Methodology A scoping review using the Joanna Briggs Institute (JBI) methodology was conducted using five information’s sources: Pubmed, Web of Science, The Cochrane Library, Scopus and Google Scholar and Open Access Scientific Repositories of Portugal and DART-Europe E-theses Portal to search also for gray literature. Data were collected between 1960-2019, with the keywords "Asbestos" and "Mesothelioma” and “Portugal”. Inclusion criteria were defined for types of participants, concept, context and types of studies.
Results Of the 1453 studies reviewed 9 were included. The oldest study is from 1986. Five studies are about incidence and survival, two are case reports, one about exposure and mortality and one about treatment. To analyse incidence and mortality, four authors used hospital data and two the data from the southern regional cancer registry (ROR). In these studies, it is also presented the description of the population in terms of mean age, type of exposure, latency time, histological type and stage.
Conclusion Portugal, such as other industrialized countries, used asbestos in a massive way, but despite this, few studies and data on the relationship between asbestos exposure and MPM are found. Dedicated studies are needed to objectively assess the true dimension of this potential problem in Portugal and characterise the different types of exposures related to MPM.
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Affiliation(s)
- C Santos
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa; Centro Hospitalar de Leiria, Portugal
| | - MA Dixe
- Instituto Politécnico de Leiria; ciTechCare, Portugal
| | - E Sacadura-Leite
- Departamento de Saúde Ocupacional e Ambiental da Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa; CISP - Centro de Investigação em Saúde Pública; Serviço de Saúde Ocupacional do CHLN, Portugal
| | - P Astoul
- Department of Thoracic Oncology, Pleural Diseases, and Interventional Pulmonology; Hôpital Nord – Aix-Marseille University, France
| | - A Sousa-Uva
- Coordenador do Departamento de Saúde Ocupacional e Ambiental da Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa; CISP - Centro de Investigação em Saúde Pública, Portugal
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