Browsing by Author "Rios, Jonathan"
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- Os desafios da medicina física e de reabilitação em Portugal durante a pandemia por COVID-19Publication . Martins, Cristiana Lopes; Rios, JonathanO impacto da pandemia pela COVID-19 é transversal a todas as áreas médicas, influenciando significativamente a prática clínica e, ainda mais importante, a saúde e qualidade de vida dos doentes.
- Ischemic stroke and subarachnoid hemorrhage following Epstein-Barr virus infectionPublication . Rios, Jonathan; Félix, Catarina; Proença, Paula; Malaia, Luís; Nzwalo, HipólitoThe epidemiological link between inflammation, infection, and acute ischemic stroke (AIS) is well known.1 Transient prothrombotic status and vasculitis are possible explanatory factors.1 Aneurysm formation in association with central nervous system infections is occasionally reported.2 Ischemic or hemorrhagic complication in relation to neurotropic virus infections, including Epstein-Barr Virus (EBV) are rarely reported in adults. Thus, we report here an extremely rare case of ischemic and hemorrhagic cerebrovascular complications in the context of EBV neuroinfection.
- Organizational factors determining access to reperfusion therapies in Ischemic Stroke-Systematic literature reviewPublication . Botelho, Ana; Rios, Jonathan; Fidalgo, Ana Paula; Ferreira, Eugénia; Nzwalo, HipólitoBackground: After onset of acute ischemic stroke (AIS), there is a limited time window for delivering acute reperfusion therapies (ART) aiming to restore normal brain circulation. Despite its unequivocal benefits, the proportion of AIS patients receiving both types of ART, thrombolysis and thrombectomy, remains very low. The organization of a stroke care pathway is one of the main factors that determine timely access to ART. The knowledge on organizational factors influencing access to ART is sparce. Hence, we sought to systematize the existing data on the type and frequency of pre-hospital and in-hospital organizational factors that determine timely access to ART in patients with AIS. Methodology: Literature review on the frequency and type of organizational factors that determine access to ART after AIS. Pubmed and Scopus databases were the primary source of data. OpenGrey and Google Scholar were used for searching grey literature. Study quality analysis was based on the Newcastle-Ottawa Scale. Results: A total of 128 studies were included. The main pre-hospital factors associated with delay or access to ART were medical emergency activation practices, pre-notification routines, ambulance use and existence of local/regional-specific strategies to mitigate the impact of geographic distance between patient locations and Stroke Unit (SU). The most common intra-hospital factors studied were specific location of SU and brain imaging room within the hospital, and the existence and promotion of specific stroke treatment protocols. Most frequent factors associated with increased access ART were periodic public education, promotion of hospital pre-notification and specific pre- and intra-hospital stroke pathways. In specific urban areas, mobile stroke units were found to be valid options to increase timely access to ART. Conclusions: Implementation of different organizational factors and strategies can reduce time delays and increase the number of AIS patients receiving ART, with most of them being replicable in any context, and some in only very specific contexts.