CES2-Artigos (em revistas ou actas indexadas)
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- Global geriatric evaluation of the Algarve populationPublication . Braz, Nídia; Pais, Sandra; Cordeiro, Clara; Oliveira, Giovanna; Conde, MonserratThe ageing of population challenges communities to adapt and evolve to accommodate the needs of people that live longer (mostly out of work, either healthy, fragile or with chronic disease). Population ageing in the Algarve is higher than in overall Portugal. Studies on health conditions, frailty risk factors and elderly specific needs are undeveloped in Portugal and unknown in the Algarve. Objective To prepare a tool for Global Geriatric Evaluation, to be used in the “Survey of Health and Ageing in the Region of Algarve - SHARA”, a commitment to “European Innovation Partnership on Active and Healthy Ageing”. Methods A preliminary version of the screening tool, which includes well-known instruments to measure health condition (EASY-care), risk of fall (Tinetty), physical activity (Baecke’s modified questionnaire), nutritional condition (MNA), cognitive and depressive status (MMSE, Yesavage geriatric depression scale), together with socio-demographic characteristics, was applied to an independent sample of subjects from an elderly community centre - ARPI (“Associação de Reformados, Pensionistas e Idosos do Concelho de Faro”), with ages between 55 and 89. Results ARPI is mostly frequented by women, who either have risk of malnutrition or malnutrition incidence, a relevant risk of fall or are physically active. Those who live alone, show a higher risk of fall. Conclusions ARPI members are active, but with risk of malnutrition and fall, suggesting the relevance and importance of future interventions in these areas. The proposed screening tool showed to be adequate for the SHARA study, suitable to provide wider information on frailty.
- Self-care improvement after a pharmaceutical intervention in elderly type 2 diabetic patientsPublication . Nascimento, Tânia; Braz, Nidia; Gomes, Eurico; Fernandez-Arche, Angeles; De La Puerta, RocioDiabetes mellitus involves long-term complications that affect diabetic patients’ quality of life. The best way to prevent these complications is that patients achieve good metabolic control. In order to reach this goal, patients are requested to acquire daily behaviours (self-care). Such behaviours are sometimes hard to adhere, because they require changes in habits acquired over time. The aim of the present study is to evaluate the improvement on self-care after a pharmaceutical intervention on home regime patients. We performed a controlled experimental comparative study with a follow up of 6 months, on 87 patients, randomized in control group (n=43) and intervention group (n=44). We accessed sociodemographic and clinical data (glycaemic profile), as well as adherence to drug therapy and self-assessed care (before-after).In the intervention group, mean age was 74.2±5.4 years, and the median time of T2DM diagnosis was 14.7±8.5years. At the end of study, the decrease in fasting blood glucose was higher in the intervention group patients than that observed in the control group (50.2mg/dL), with statistically significant difference (p<0.05), as well as the decrease verified in HbA1c. In self-care adherence, alterations in the levels of adherence of the general nutrition and physical exercise dimensions became evident, with an increase in the number of days of adherence. On medication adherence statistically significant alterations (p<0.05) were also recorded. We can conclude that an individualized pharmaceutical intervention can improve self-care behaviours, as well as medication adherence, contributing to better metabolic control.
- Ageing and nutritional therapy adherence in type 2 diabetesPublication . Pinto, Ezequiel; Braz, NidiaThe prevalence of diabetes increases with age, which is also a determinant of nutrition therapy adherence. This descriptive study was conducted in a non-random sample of 66 patients aged between 47 and 75 years (M=61.5; SD=8.0) receiving health care in a Diabetes Clinic in the municipality of Faro, in the Portuguese region of the Algarve. We aimed to assess the association between age and the clinical characteristics of type 2 diabetes and to analyze the perceptions regarding the barriers to an adequate diet. Glycated hemoglobin (HbA1c) (r=-0.372, P<0.001) showed a negative correlation with age, suggesting that older patients have a better glucose control. Older age is also correlated with a higher number of daily meals (r=0.263) and lower intake of energy (r=-0.334), protein (r=-0.249), sugars (r=-0.301), and water (r=-0.223). Forty-six patients (69.7%) had a mean excess energy intake of 384 kcal (SD=630.2), when compared with individual nutritional energy estimated requirements. Excess energy intake was uncorrelated with age (r=-0.138, P=0.269). Older patients also seem more confused with the nutrition information they received (r=0.248) and feel that they need more advice on what is a proper diet (r=0.242). Nutrition education interventions in this population must be tailored in order to address these factors
- Functional aspects in ageing adults with diabetic neuropathy. A reviewPublication . Braz, Nidia; Botelho, Marta; Conde, MonserratDiabetic Peripheral Neuropathy (DPN) is highly prevalent among diabetic ageing adults. The sensory and motor impairments caused by this long-term complication lead to poorer physical functioning, postural control and balance. These changes affect the activities of daily living and increase the risk of falling, subsequently leading to increased morbidity and decreased quality of life. Early detection of such functional limitations is important, as it may influence the effectiveness of rehabilitation programs and prevent further functional dependence. This review focuses on functional aspects related to balance, postural control and mobility in ageing adults suffering from DPN, as well as their assessment by valid, reliable and low-cost performance-based measurements. PUBMED was searched for articles in English published between 2004 and 2014. Search terms included diabetic neuropathy, balance, postural control, functional mobility, and functional outcomes. Reviewed literature indicates that simple and low-cost measurements, easy to include in clinical routines, can be used for screening impairments in complex functions, such as balance and mobility. Some studies have also been able to correlate results from DPN severity scales with those of functional tests, showing that applying such tests may improve the early diagnosis of this neurological disorder. Berg Balance Scale, Dynamic Gait Index, Functional Reach Test, and Time Up and Go already have modified cut-off points for the Diabetes Mellitus older population, but need validation for ageing adults with DPN. Further research on this subject should be addressed, in order to improve assessment outcomes.
- Uma experiência com a Global Trigger Tool no estudo dos eventos adversos num serviço de medicinaPublication . Pierdevara, Ludmila; Ventura, Inês Margarida; Eiras, Margarida; Gracias, Amália Maria Brito; Silva, Carina Soares daBackground: Health care provision is associated with adverse events (AEs) which harm hospitalized patients. Objectives: To study AEs in a medical ward. Methodology: A quantitative, descriptive, observational and retrospective study was conducted from 1 September 2014 to 31 December 2014 in a medical ward of the Algarve Hospital Center. The instrument used to identify the AEs was the Global Trigger Tool (GTT). All the patients who were discharged between 1 January 2014 and 30 September 2014 were listed. Results: The interrater agreement concerning the AE classification, using the Kappa value, proved to be perfect. A total of 278 triggers were identified, of which 124 resulted in AEs: 44.6% of AEs occurred during the hospitalization, and 9.4% of the patients presented AEs at the moment of admission. We found a total of 62.63 AEs per 1,000 patient days, 137.8 AE per 100 admissions, and one AE in 31.1% of the cases during hospitalization. Conclusion: The GGT proved to be a useful tool to analyze AEs in hospital settings.
- Postprandial glycaemia in type-2 diabetes: A non-random trial according to glucose controlPublication . Pinto, Ezequiel; Braz, Nídia; Nascimento, Tânia; Gomes, EuricoIntroduction: Postprandial glycaemia contributes significantly to the overall glycaemic control and is a risk factor for cardiovascular complications in type-2 diabetes patients. As patients with good glycaemic control can show elevated postprandial hyperglycaemia, especially after breakfast, the study of glucose response after this meal can provide insight that will help nutrition intervention and treatment. Methods: A group of 66 patients previously diagnosed with type 2 diabetes mellitus was recruited and categorized into patients with HbA1c below 7% (proper glycaemic control) and patients with HbA1c of 7% or above (poor glycaemic control). All subjects were interviewed and offered a nutritionally controlled breakfast. Glucose response was monitored for 120 minutes after the meal. Results: There are no significant differences in postprandial glycaemia between patients with adequate glycaemic control and those with poor glycaemic control, up to 120 minutes after breakfast. The reported prevalence of self-monitoring of blood glucose is low. Mean differences between pre-prandial and postprandial glucose were not correlated with body mass index, age at diagnosis, diabetes duration, HbA1c, energy or carbohydrate intake. Conclusions: Patients which are considered as having a proper glucose control may be unaware that they exceed the recommended rise in postprandial glycaemia. Meal plans should take into account the need to regulate postprandial glycaemia and patients should be empowered to overcome their low prevalence of glucose self-measure.
- Do patients value nutritional therapy? A quantitative study in type- 2 diabetes patientsPublication . Pinto, Ezequiel; Braz, Nídia; Nascimento, Tânia; Gomes, EuricoType 2 diabetes patients’ adherence to pharmacotherapy is higher than adherence to nutritional therapy or lifestyle change behaviours, and patients do not value nutritional therapy in the same level as they value other types of interventions. This study aimed to analyse the value that T2DM patients place on nutritional therapy and to identify perceived barriers to nutritional therapy adherence. Methods: A non-random sample of 62 patients receiving health care in a Diabetes Clinic in the municipality of Faro, in the Portuguese region of the Algarve, was interviewed with a semi-structured protocol regarding sociodemographic characteristics, lifestyle, physical activity, and dietary habits. Additional data were collected from the patient’s clinical files and by conducting anthropometric assessment using standard methods.
- Synthesis and characterization of Locust Bean Gum derivatives and their application in the production of nanoparticlesPublication . Braz, Luis; Grenha, Ana; Corvo, Marta C.; Lourenço, João P.; Ferreira, Domingos; Sarmento, Bruno; Costa, Ana M. Rosa daThe development of LBG-based nanoparticles intending an application in oral immunization is presented. Nanoparticle production occurred by mild polyelectrolyte complexation, requiring the chemical modification of LBG. Three LBG derivatives were synthesized, namely a positively charged ammonium derivative (LBGA) and negatively charged sulfate (LBGS) and carboxylate (LBGC) derivatives. These were characterized by Fourier-transform infrared spectroscopy, elemental analysis, nuclear magnetic resonance spectroscopy, gel permeation chromatography, and x-ray diffraction. As a pharmaceutical application was aimed, a toxicological analysis of the derivatives was performed by both MTT test and LDH release assay. Several nanoparticle formulations were produced using LBGA or chitosan (CS) as positively charged polymers, and LBGC or LBGS as negatively charged counterparts, producing nanoparticles with adequate properties regarding an application in oral immunization.
- Impacts of in vivo and in vitro exposures to tamoxifen: comparative effects on human cells and marine organismsPublication . Fonseca, T. G.; Carriço, T.; Fernandes, E.; Abessa, D. M. S.; Tavares, A.; Bebianno, M.Tamoxifen (TAM) is a first generation-SERM administered for hormone receptor-positive (HER+) breast cancer in both pre- and post-menopausal patients and may undergo metabolic activation in organisms that share similar receptors and thus face comparable mechanisms of response. The present study aimed to assess whether environmental trace concentrations of TAM are bioavailable to the filter feeder M. galloprovincialis (100 ng L-1) and to the deposit feeder N. diversicolor (0.5, 10, 25 and 100 ng L-1) after 14 days of exposure. Behavioural impairment (burrowing kinetic), neurotoxicity (AChE activity), endocrine disruption by alkali-labile phosphate (ALP) content, oxidative stress (SOD, CAT, GPXs activities), biotransformation (GST activity), oxidative damage (LPO) and genotoxicity (DNA damage) were assessed. Moreover, this study also pertained to compare TAM cytotoxicity effects to mussels and targeted human (i.e. immortalized retinal pigment epithelium - RPE; and human transformed endothelial cells - HeLa) cell lines, in a range of concentrations from 0.5 ng L-1 to 50 μg L-1. In polychaetes N. diversicolor, TAM exerted remarkable oxidative stress and damage at the lowest concentration (0.5 ng L-1), whereas significant genotoxicity was reported at the highest exposure level (100 ng L-1). In mussels M. galloprovincialis, 100 ng L-1 TAM caused endocrine disruption in males, neurotoxicity, and an induction in GST activity and LPO byproducts in gills, corroborating in genotoxicity over the exposure days. Although cytotoxicity assays conducted with mussel haemocytes following in vivo exposure was not effective, in vitro exposure showed to be a feasible alternative, with comparable sensitivity to human cell line (HeLa).
- An assessment of the psychometric properties of the Brief Sensation Seeking Scale and its prediction in safety performance in a Portuguese adult samplePublication . Sousa, Cátia; Sousa, António; Pinto, Ezequiel; Gonçalves, GabrielaThis study aims to present the psychometric properties of the Brief Sensation Seeking Scale in a Portuguese sample. Three studies were performed: the first study provides psychometric evidence pertaining to its reliability and factor structure, an analysis of the measurement invariance of the BSSS across gender and age, and an examination of the differences scores on the scale regarding gender, age and marital status (n = 526); the second study consists of an assessment of convergent, discriminant and postdictive validity (n = 240); and the third study includes a test-retest of the BSSS (n = 72). A four-factor model yielded the best fit to the data with good reliability and validity. The scale showed non-invariance between genders and between ages, which makes it less generalizable and susceptible to different populations. Convergent validity with the variables risk taking, need for arousal and extraversion, and discriminant validity between neuroticism, agreeableness and conscientiousness, were demonstrated. The scale presents good temporal stability and represent an important tool for psychological assessment of personality and behavior, and as a predictor of safety performance.