Percorrer por autor "Carvalho, Pedro"
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- Development and validation of risk matrices for Crohn's Disease outcomes in patients who underwent early therapeutic interventionsPublication . Dias, Cláudia Camila; Rodrigues, Pedro Pereira; Coelho, Rosa; Santos, Paula Moura; Fernandes, Samuel; Lago, Paula; Caetano, Cidalina; Rodrigues, Angela; Portela, Francisco; Oliveira, Ana; Ministro, Paula; Cancela, Eugenia; Vieira, Ana Isabel; Barosa, Rita; Cotter, Jose; Carvalho, Pedro; Cremers, Isabelle; Trabulo, Daniel; Caldeira, Paulo; Antunes, Artur; Rosa, Isadora; Moleiro, Joana; Peixe, Paula; Herculano, Rita; Gonçalves, Raquel; Gonçalves, Bruno; Sousa, Helena Tavares; Contente, Luis; Morna, Henrique; Lopes, Susana; Magro, FernandoIntroduction: The establishment of prognostic models for Crohn's disease [CD] is highly desirable, as they have the potential to guide physicians in the decision-making process concerning therapeutic choices, thus improving patients' health and quality of life. Our aim was to derive models for disabling CD and reoperation based solely on clinical/demographic data. Methods: A multicentric and retrospectively enrolled cohort of CD patients, subject to early surgery or immunosuppression, was analysed in order to build Bayesian network models and risk matrices. The final results were validated internally and with a multicentric and prospectively enrolled cohort. Results: The derivation cohort included a total of 489 CD patients [64% with disabling disease and 18% who needed reoperation], while the validation cohort included 129 CD patients with similar outcome proportions. The Bayesian models achieved an area under the curve of 78% for disabling disease and 86% for reoperation. Age at diagnosis, perianal disease, disease aggressiveness and early therapeutic decisions were found to be significant factors, and were used to construct user-friendly matrices depicting the probability of each outcome in patients with various combinations of these factors. The matrices exhibit good performance for the most important criteria: disabling disease positive post-test odds = 8.00 [2.72-23.44] and reoperation negative post-test odds = 0.02 [0.00-0.11]. Conclusions: Clinical and demographical risk factors for disabling CD and reoperation were determined and their impact was quantified by means of risk matrices, which are applicable as bedside clinical tools that can help physicians during therapeutic decisions in early disease management.
- Impact of early surgery and immunosuppression on Crohn's disease disabling outcomesPublication . Magro, Fernando; Dias, Cláudia C.; Coelho, Rosa; Santos, Paula M.; Fernandes, Samuel; Caetano, Cidalina; Rodrigues, Angela; Portela, Francisco; Oliveira, Ana; Ministro, Paula; Cancela, Eugenia; Vieira, Ana I.; Barosa, Rita; Cotter, Jose; Carvalho, Pedro; Cremers, Isabelle; Trabulo, Daniel; Caldeira, Paulo; Antunes, Artur; Rosa, Isadora; Moleiro, Joana; Peixe, Paula; Herculano, Rita; Gonçalves, Raquel; Gonçalves, Bruno; Sousa, Helena Tavares; Contente, Luis; Morna, Henrique; Lopes, SusanaBackground and Aims: The definition of early therapeutic strategies to control Crohn's disease aggressiveness and prevent recurrence is key to improve clinical practice. This study explores the impact of early surgery and immunosuppression onset in the occurrence of disabling outcomes. Methods: This was a multicentric and retrospective study with 754 patients with Crohn's disease, who were stratified according to the need for an early surgery (group S) or not (group I) and further divided according to the time elapsed from the beginning of the follow-up to the start of immunosuppression therapy. Results: The rate of disabling events was similar in both groups (S: 77% versus I: 76%, P = 0.700). The percentage of patients who needed surgery after or during immunosuppression therapy was higher among group S, both for first surgeries after the index event (38% of groups S versus 21% of group I, P, 0.001) and for reoperations (38% of groups S versus 12% of group I, P < 0.001). The time elapsed to reoperation was shorter in group I (HR = 2.340 [1.367-4.005]), stratified for the onset of immunosuppression. Moreover, reoperation was far more common among patients who had a late start of immunosuppression (S-36: 50% versus S0-6: 27% and S6-36: 25%, P < 0.001) and (I-36: 16% versus I0-6: 5% and I6-36: 7%, P, 0.001). Conclusions: Although neither early surgery nor immunosuppression seem to be able to prevent global disabling disease, an early start of immunosuppression by itself is associated with fewer surgeries and should be considered in daily practice as a preventive strategy.
- Opportunistic data for assessing abundance and site fidelity of fin whales (Balaenoptera physalus) in the Faro area, PortugalPublication . Gennari, Ginevra; Rodrigues, Alfredo; Carvalho, Pedro; Gil, Susana; Magno, Ramiro; Castilho, Rita; Peres dos Santos, Rui PedroThe distribution and migration of fin whales (Balaenoptera physalus) remain poorly understood in parts of the North Atlantic. One of these regions is the Algarve in southern Portugal, which is shaped by seasonal upwelling and the exchange of Atlantic and Mediterranean waters. This area represents a potentially critical yet poorly understood habitat for this species. This study presents the first comprehensive assessment of fin whale abundance and site fidelity in the Faro area, located approximately between 36–37° N and 8–7° W. Data was collected from 2020 to 2024 through photoidentification and GPS vessel tracks, in collaboration with a local whale-watching company. A regional catalog of 86 individuals was established, and an open spatially explicit capture-recapture model estimated a population of 1.476 individuals. Sightings peaked in spring, likely linked to phytoplankton blooms and foraging opportunities. While re-sighting rates were low, some individuals returned across years, indicating possible seasonal site fidelity. Our results demonstrate the value of data collected from platforms of opportunity in an under-surveyed region, providing a foundation for ongoing monitoring efforts. Results also highlight the Faro area’s ecological relevance as a seasonal feeding ground for fin whales and offer insights to support future conservation in the eastern North Atlantic.
- Portuguese Football Federation consensus statement 2020: nutrition and performance in footballPublication . Abreu, Rodrigo; Figueiredo, Pedro; Beckert, Paulo; Marques, José P; Amorim, Samuel; Caetano, Carlos; Carvalho, Pedro; Sá, Carla; Cotovio, Ricardo; Cruz, Joana; Dias, Tiago; Fernandes, Gonçalo; Gonçalves, Elton; Leão, César; Leitão, Alexandre; Lopes, João; Machado, Eduardo; Neves, Mónica; Oliveira, André; Pereira, Ana I; Pereira, Bruno; Ribeiro, Fernando; Silva, Luis M; Sousa, Filipe; Tinoco, Tânia; Teixeira, Vitor H; Sousa, Monica; Brito, JoãoNutrition is an undeniable part of promoting health and performance among football (soccer) players. Nevertheless, nutritional strategies adopted in elite football can vary significantly depending on culture, habit and practical constraints and might not always be supported by scientific evidence. Therefore, a group of 28 Portuguese experts on sports nutrition, sports science and sports medicine sought to discuss current practices in the elite football landscape and review the existing evidence on nutritional strategies to be applied when supporting football players. Starting from understanding football's physical and physiological demands, five different moments were identified: preparing to play, match-day, recovery after matches, between matches and during injury or rehabilitation periods. When applicable, specificities of nutritional support to young athletes and female players were also addressed. The result is a set of practical recommendations that gathered consensus among involved experts, highlighting carbohydrates periodisation, hydration and conscious use of dietary supplements.