Faculdade de Medicina e Ciências Biomédicas
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Percorrer Faculdade de Medicina e Ciências Biomédicas por Objetivos de Desenvolvimento Sustentável (ODS) "16:Paz, Justiça e Instituições Eficazes"
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- Drug-related glomerular phenotypes: a global pharmacovigilance perspectivePublication . Baptista, Alexandre; Macedo, Ana; Marreiros, Ana; Coelho, André; Perazella, Mark A.Abstract: Introduction: Adverse drug reactions are a significant problem in modern society, stemming from the increase in prescribed medications, over-the-counter drugs, and overall polypharmacy. Glomerular disorders are one of the frequently reported renal conditions associated with medication use. VigiBase is a significant tool for evaluating events associated with drug use, and, to the authors’ knowledge, no study has yet assessed this database to identify the primary medications associated with glomerular disorders. Materials and Methods: We collected data from VigiBase for 54 years and evaluated data based on global frequencies, disproportionality (IC025 values), nephrotoxic potential, and physiopathological mechanisms. Results: Over the evaluation period, 33.932.051 spontaneous notifications of adverse drug reactions reported in VigiBase were assessed, from which 106.775 notifications of drug-associated glomerular disorders were extracted. The isolated medications were classified as ‘potential nephrotoxins’ (47.0%), with 40% of the medications lacking scientific references to report any association with the development of glomerular disorders. Among the evaluated medications, Inotersen (IC025 of 8.3), Penicillamine (IC025 6.8), Bevacizumab (IC025 5.9) and Lenvatinib (IC025 5.4) were identified as having the strongest association with these glomerular disorders. For medications classified as ‘non-nephrotoxic’, a high disproportionality index was observed, suggesting drugs that might be considered as new potential nephrotoxins. Conclusions: Drug-induced glomerular disorders were significantly associated with medications that had no established nephrotoxic role but demonstrated a high disproportionality index in VigiBase. These newly alleged nephrotoxic drugs warrant further evaluation in dedicated studies to assess their true nephrotoxic potential.
- Risk factors for non-communicable diseases in refugees, asylum seekers, and subsidiary protection beneficiaries resettled or relocated in Portugal between 2015 and 2020Publication . Pinto de Oliveira, Ana; Conceição, Cláudia; Fronteira, InêsAbstract: Non-communicable diseases, previously thought of as a problem of high-income countries, now coexist in low- and middle-income countries, including the countries of origin for many refugees traveling to Europe. We aimed to describe the prevalence of risk factors for non-communicable diseases among refugees, asylum seekers, and subsidiary protection beneficiaries resettled or relocated in Portugal between 2015 and 2020 and compare these to the prevalence of risk factors in the 12 months before they left their country of origin. A cross-sectional study was conducted between 2019 and 2020 of all refugees, asylum seekers, and subsidiary protection beneficiaries attending a Lisbon, Portugal refugee center. Behavioral and biological risk factors were assessed using the WHO STEPwise modified questionnaire. A descriptive statistical analysis was conducted, which included 80 respondents, mainly men, with an average age of of 30.3 ± 9.8 years. The prevalence of several behavioral risk factors for non-communicable diseases among refugees, asylum seekers, and subsidiary protection beneficiaries was higher at the time of the study than in the 12 months before leaving the country of origin. Differences between men and women were noted in tobacco (49.1% vs. 25.9%) and alcohol use (43.4% vs. 18.5%) in the receiving country. Overweight and obesity also showed differences by gender (7.5% vs. 11.1% and 39.6% vs. 48.1%). The prevalence of suicidal ideation and suicidalplanning was high, and varied from 6.3% and 20% in the country of origin to 16.3% and 38.5% respectively in the receiving country, however the prevalence of suicide attempts was lower in the receiving country (66.7%) compared to the country of origin (100.0%). Information on health and social determinants is critical to identify priorities and increase access to access to gender-specific health and community level interventions, including mental health, to reduce risk factors associated with refugee relocation and resettlement.
- Sources of discomfort and treatment strategies for trauma patients in the pre-hospital setting: a scoping reviewPublication . Melo, Filipe; Santos, Margarida Reis; Sousa, Miguel Castelo-Branco; Mota, Cátia; Mota, MauroIntroduction: Trauma remains a leading cause of mortality and long-term disability worldwide, often causing significant discomfort during prehospital care. Addressing these discomforts effectively is crucial for improving patient outcomes. This scoping review aimed to identify and categorize the types of discomforts experienced by adult trauma victims in prehospital settings and map the pharmacologic and nonpharmacologic interventions used to mitigate them. Methods: This scoping review followed the Joanna Briggs Institute framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive search was performed in databases including MEDLINE, CINAHL, Scopus, Embase, PsycINFO, Joanna Briggs Institute Evidence Synthesis, Cochrane Database, and relevant gray literature sources. Studiesinvolving adult trauma patients(>_18 years) in prehospital care that reported on discomfort and interventions were included without restrictions on publication date. Results: Seventeen studies met the inclusion criteria, covering various international contexts. Acute pain was the most frequently reported discomfort, followed by anxiety, fear, cold-induced discomfort, and discomfort caused by immobilization. Pharmacologic interventions predominantly included opioids, nonsteroidal anti-inflammatory drugs, paracetamol, ketamine, and methoxyflurane, whereas nonpharmacologic interventions comprised acupressure, transcutaneous electrical nerve stimulation, cryotherapy, warming measures, communication strategies, and emotional support. Nonpharmacologic interventions, especially acupressure and communication techniques, showed promising results in reducing pain and anxiety. Discussion: The findings underline the multidimensional nature of discomfort in prehospital trauma care and highlight effective interventions, including pharmacologic and complementary nonpharmacologic strategies. However, significant gaps remain regarding standardized assessment tools for non–pain-related discomforts and combined interventions. This review underscores the necessity for comprehensive management protocols and further research to optimize patient comfort and care outcomes in trauma settings.