ESS2-Artigos (em revistas ou actas indexadas)
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- Bone mineral density and body composition among individuals who practice sports with mechanical impact and sedentary activitiesPublication . Pinheiro, João; Ribeiro, Luís Pedro; Coelho-e-Silva, ManuelThe purpose of this study was to evaluate indicators of bone health associated with sports practice in male adolescents using dual-energy X-ray absorptiometry (DXA) to measure bone mineral content (BMC), density (BMD), and body composition (BC) for the whole body (WB) and specific regions. This cross-sectional study involved 65 individuals (18–35 years). Athletes had higher BMD for WB (1.064 ± 0.121 g/m−2) than sedentary individuals (0.753 ± 0.129 g/cm−2). Differences were also observed within specific regions such as the trunk, upper and lower limbs. Individuals who practice regular sports present improved bone health indicators compared to their sedentary peers.
- Chemical and health risks of swimming pool maintenance workersPublication . Silva, Adriana; Pinto, Ezequiel; Braz, Nídia Maria Dias Azinheira RebeloSwimming pool maintenance workers are exposed to occupational hazards, as it involves the regular handling of toxic chemicals. These exposures can result in acute reactions or chronic complications. The present study, still in the design phase, aims to describe the chemical and biological exposure of workers of a swimming pool maintenance company and to verify its compliance with the safety standards in force. A quantitative questionnaire will identify the use of personal protective equipment, chemical agents, and handling procedures, particularly regarding the time and frequency of use.
- Commentary on: nurses’ perceptions of artificial intelligence (AI) integration into practice: an integrative reviewPublication . Xavier, Tânia; Oliveira, ClaudiaWe are writing this letter to congratulate you on the paper ‘Nurses’ perceptions of artificial intelligence (AI) integration into practice: An integrative review’ by Lora and Foran, recently published in your journal. In this paper the authors synthesise remarkable, valuable and challenging aspects of the new era of artificial intelligence (AI) in the clinical practice of nursing. AI has been introduced into the most diverse areas of knowledge, opening a vast range of possibilities. This integrative review makes a timely and relevant contribution to the growing body of literature on the intersection between nursing and AI. The authors show that the practice of nursing, especially in the perioperative environment, is no exception.
- Editorial: Innovative teaching and learning in health education and promotionPublication . da Costa, Emilia; Ruiz Fernández, María Dolores; Fernández Medina, Isabel María; Jimenez Lasserrotte, Maria del Mar; Ventura-Miranda, Maria IsabelHealth education and health promotion are undergoing profound transformation. Demographic transitions, aging populations, increasing multimorbidity, persistent inequities, and rapid technological change are reshaping how learners understand and navigate health. In this evolving context, traditional knowledge-transmission models are no longer sufficient to prepare future professionals for complex, multicultural and digitally mediated environments. Innovation in teaching and learning has therefore become essential, not only to improve learning outcomes, but to strengthen ethical reasoning, equity, and learner autonomy. This global shift echoes recent OECD (1) analyses highlighting how digitalisation, demographic aging and widening social disparities are redefining the competencies required of tomorrow’s health workforce and calling for educational approaches attuned to complexity and uncertainty. It is also consistent with the World Health Organization’s call for transformative health workforce education, which stresses that conventional training models can no longer meet the demands posed by demographic change, chronic disease burdens, technological acceleration and growing inequities.
- The effect of nutritional intervention in nutritional risk screening on hospitalised lung cancer patientsPublication . de Oliveira, Raquel; Cabrita, Bruno; Cunha, Ângela; Silva, Sónia; Lima, João P. M.; Martins, Diana; Mendes, FernandoBackground: Lung cancer (LC) patients are prone to suffer from malnutrition. Malnutrition negatively affects patients’ response to therapy, increases the incidence of treatment-related side effects, and decreases survival. Early identification of LC patients who are malnourished or at risk of malnutrition can promote recovery and improve prognosis. Objective: This study aimed to assess the risk and nutritional status of lung cancer patients who are hospitalised, as well as to evaluate the impact of nutritional intervention on the risk of malnutrition. Methods: From January 2022 to December 2023, 53 LC patients hospitalised in a pulmonology department had their nutritional risk (initial and final) and nutritional status (initial) assessed. All were selected for nutritional intervention. Nutrition counselling was the first intervention option, along with dietary changes with/without oral nutritional supplements. Results: At the time of hospitalisation, 90.6% of the patients were at nutritional risk, 45.3% were classified as moderately malnourished, and 35.8% were classified as severely underweight. After the hospitalisation, 73.6% were at nutritional risk at the time of discharge, suggesting a statistically significant decrease in the number of patients with nutritional risk. Conclusions: Most LC patients hospitalised presented an altered nutritional status. Our study suggests that a nutritional intervention must be implemented to reduce malnutrition risk, which may impact prognosis. The comprehensive nutritional problems experienced by LC patients require nutritional assessment and improved individually tailored nutritional support.
- Frailty and outcomes in elderly ICU patients: insights from a portuguese cohortPublication . Lourenço, Eva; Rodrigues, Isabel; Sampaio, Mário; da Costa, EmiliaBackground: Frailty is a key determinant of outcomes in critically ill elderly patients, but data from Portugal remain limited. To our knowledge, this is the first study to examine the prevalence and prognostic impact of frailty among elderly ICU patients in a Portuguese hospital setting. Objective: To determine the prevalence of frailty among elderly patients admitted to an intensive care unit (ICU) in southern Portugal and to examine its crude associations with illness severity, organ support, and mortality outcomes. Methods: We conducted a retrospective cohort study including 125 patients aged ≥ 65 years admitted to the polyvalent ICU of Hospital de Faro over the last six months of 2024. Data included demographics, comorbidities, Charlson Comorbidity Index (CCI), severity scores (SOFA, SAPS II, APACHE II), and frailty status assessed by the Clinical Frailty Scale (CFS). Outcomes were the need for organ support, ICU and hospital mortality, and length of stay. Results: Frailty (CFS ≥ 5) was identified in 30.4% of patients. Frail patients were older, had higher comorbidity burden (CCI), and presented with significantly higher severity scores at admission. They also required more invasive support, including vasopressors and invasive mechanical ventilation, while acute kidney injury (AKI) requiring renal replacement therapy (RRT) was similar between groups. ICU mortality was significantly higher among frail patients (50.0% vs. 31.0%), as was hospital mortality (76.3% vs. 33.3%). Length of ICU stay did not differ, although frail patients tended to have longer hospitalizations overall. Conclusions: Frailty was highly prevalent and strongly associated with increased severity, greater need for organ support, and higher mortality. Routine frailty assessment at ICU admission may enhance prognostic accuracy and support patient-centered decision-making.
- High vs low protein intake in chronic critical illness: a systematic review and meta-analysisPublication . Castro, Sílvia; Tome, Ana Maria; Granja, C.; Macedo, A.; Binnie, AlexandraBackground & aims: Patients with persistent organ dysfunction after the first week of intensive care unit (ICU) admission are considered to have chronic critical illness (CCI). Acquired muscle weakness is a common feature of CCI that is accompanied by loss of muscle mass and electromyographic features of myopathy. Optimizing protein intake may help prevent acquired muscle weakness and/or promote muscle recovery, however, the optimal level of protein intake in CCI is uncertain and there is a lack of consensus in published nutritional guidelines. This systematic review focuses on the impact of high versus low protein intake as part of a nutritional strategy for patients with CCI. Methods: The terms “protein intake” and “critically ill” were systematically searched in PUBMED, CENTRAL (Cochrane Central Register of Controlled Trials), and WEB OF SCIENCE on 06/01/2023. We included studies that (1) enrolled critically ill adults (aged 18 years or over) who were in the ICU for more than 7 days and that compared (2) protein intake above and below 1.3 gr/kg administered by any route (enteral and/or parenteral), (3) had an intervention period that occurred primarily after the first 7 days of critical illness and (4) reported clinical outcomes including length of ICU and hospital stay, duration of invasive mechanical ventilation (IMV), mortality, ICU acquired infections, muscle mass and physical function. Studies pertaining to elective surgery, those with intervention periods shorter than 7 days or occurring primarily within the first 7 days of critical illness, those measuring only laboratory parameters as outcomes, and safety and feasibility studies were excluded. Results: Four studies were included (N ¼ 1730) in the meta-analysis and systematic review. Higher (>1.3 g/kg/d) versus lower protein intake was associated with a decrease in early mortality (defined as ICU or 28-day mortality) hazard ratio (HR) 0.42 (95 % confidence interval (CI): 0.26e0.70, P < 0.001), but had no impact on late mortality (defined as the latest mortality timepoint in each study): HR 0.93 (95 % CI 0.76e1.15, P ¼ 0.51). There was no significant difference between intervention and control groups with respect to duration of IMV, duration of ICU or hospital stay, muscle mass, or the incidence of ICUacquired infections. One study reported improvements in physical function at 3 and 6 months in the intervention group. Conclusion: After the first week of critical illness, increasing protein intake to >1.3 g/kg/d may improve early mortality but not late mortality or other clinical outcomes. The small number of relevant studies and the heterogeneity of outcomes assessed, weaken these conclusions. Further studies are warranted to discern whether higher protein intake is beneficial in chronic critical illness. PROSPERO registration number: CRD42023403554; PROSPERO registration name: “The effect of higher than 1,3 g/kg of protein versus lower intake in chronic critically ill patients”
- The immune tumor microenvironment in gliomas: may CITED2 play a role?Publication . Teotónio Fernandes, Mónica AlexandraGliomas are the most common brain cancers, resulting from transformed glial cells. CITED2 is a co-transcriptional regulator previously implicated in several types of cancer, affecting both cellintrinsic processes and the microenvironment. Because in breast cancer it was shown to contribute to the recruitment of macrophages and their polarization to an immunosuppressive phenotype, a potential similar role was explored in gliomas. By analyzing publicly available databases using a set of bioinformatics tools, it was found that CITED2 is overexpressed in higher-grade gliomas and contributes to an adverse prognosis. In addition, CITED2 expression correlates with macrophage infiltration and a M2 phenotype.
- Impact of bariatric and metabolic surgery on sarcopenia-related parameters according to the EWGSOP2 consensus criteria in persons living with obesityPublication . Cardoso, Paulo Alexandre e Castro; Santos, Tânia V.; Ramon-Krauel, Marta; Pais, Sandra; De Sousa-Coelho, Ana LuísaAlthough bariatric and metabolic surgery (BS) has proved effective in the treatment of obesity based on the reduction in fat mass and the remission of comorbidities, there is also loss of lean mass after BS which could compromise muscle functionality. According to the European Working Group on Sarcopenia in Older People (EWGSOP), sarcopenia is a disease associated with loss of muscle mass, strength, and function. Through a comprehensive review of the literature, we identified a range of studies focusing on evaluating sarcopenia-related parameters according to the EWGSOP2 consensus criteria, before and after BS. Although most studies reported reductions in skeletal muscle mass and absolute muscle strength after surgery, improvements in muscle functionality were generally achieved, independent of the type of BS.
- Impacto dos grupos de apoio na sobrecarga de cuidadores familiares em PortugalPublication . Bernabéu-Álvarez, Claudia; Costa, Emília IsabelObjetivo: Analisar a relação entre a sobrecarga do cuidador familiar e o apoio social com a participação em grupos de apoio presenciais e virtuais. Métodos: Estudo pré-experimental. Critérios de inclusão: cuidadores informais, maiores de idade, residentes na região centro-sul de Portugal. Variável independente: participação num grupo de apoio presencial (GA), num fórum virtual (FV) ou nenhum grupo (GC). Variáveis dependentes: sobrecarga de cuidado (Índice de Esforço do Cuidador) e apoio social percebido (escala MOS). Análise descritiva, binária e multivariada com o programa estatístico SPSS 22. Resultados: Participaram 109 cuidadores, principalmente mulheres, cuidando dos seus filhos. 47,7% sofreram sobrecarga pelo cuidado, sendo mais alta no GC. O apoio social foi bom em 64,2% dos participantes, sendo maior no GA. Houve uma associação significativa com o género e a rede social (ser mulher está associado a uma maior sobrecarga, enquanto uma ampla rede social diminui a sobrecarga do cuidador). A participação num GA ou FV melhorou significativamente a rede e o apoio social. Conclusão: A participação em grupos de apoio, tanto presenciais quanto virtuais, tem uma relação positiva significativa com a redução da sobrecarga do cuidador e o aumento do apoio social percebido. Estes grupos de apoio são recursos essenciais para os cuidadores informais, ajudando a mitigar os efeitos negativos do cuidado e fortalecendo as suas redes sociais e o apoio. Portanto, promover a participação em tais grupos pode ser uma estratégia eficaz para melhorar o bem-estar dos cuidadores familiares.