ESS2-Artigos (em revistas ou actas indexadas)
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- Does vitamin D supplementation impact serotonin levels? A systematic review and meta-analysis.Publication . Alimohammadi-Kamalabadi, Malek; Ziaei, Somayeh; Hasani, Motahareh; Mohammadi, Shooka; Mehrbod, Milad; Morvaridi, Mehrnaz; Persad, Emma; Belančić, Andrej; Malekahmadi, Mahsa; Estêvão, Maria Dulce da Mota Antunes de Oliveira ; Daneshzad, Elnaz; Heshmati, JavadVitamin D deficiency impacts a significant proportion of the world's population, and this deficiency has been linked to various conditions characterized by imbalanced serotonin regulation. The objective of this systematic review and meta-analysis was to evaluate the effect of vitamin D supplementation on serum serotonin levels. We conducted a comprehensive search of PubMed, Scopus, Cochrane Central for Randomized Clinical Trials, and Web of Science up to September 2022, without any language restrictions. The effect sizes were calculated using the standard mean difference (SMD) and 95% confidence interval (CI). Six randomized clinical trials involving 356 participants were included in the analysis. Our findings indicated no significant changes in serotonin levels between the intervention and control groups (SMD: 0.24 ng/mL, 95% CI: -0.28, 0.75, > 0.10). Subgroup analysis also did not reveal any significant changes in serotonin levels among children, participants with autism spectrum disorders, interventions lasting 10 weeks or longer, or those receiving vitamin D doses below 4000 IU/day. Although the results obtained in this systematic review are inconclusive, they support the need for further well-designed randomized trials to assess the potential role of vitamin D supplementation in regulating serotonin levels and potentially ameliorating depression and related disorders.
- Elevating elderly Cancer care: a systematic review of advanced practice nursing's role in senior oncology patients' quality of lifePublication . Useche-Guerrero, Cristian-David; Merino-Godoy, María-de-los-Ángeles; Barroso-Márquez, Eva-María; Costa, Emília Isabel; Camacho Bejarano, Rafaela; Gago-Valiente, Francisco-JavierBackground. According to projections based on current trends, it can be anticipated that from 2024 onward, approximately 70% of all cancer cases will be diagnosed in individuals 65 years and older. Given this complex intersection between population ageing and cancer incidence, it is of great importance to address this issue from a comprehensive care perspective. Here comes the importance of advanced practice nurse into play. However, this fgure is still not sufciently valued in many countries. Its roles are also not clearly defned at the international level. For this reason, a systematic review of the scientifc literature was carried out to analyze the impact of advanced practice nurse on the quality of life of older adults with cancer. Methods. Searches were carried out in PubMed, Web of Science (WoS), Scopus, CINAHL, LILACS, and ScienceDirect databases. Tey were limited to studies conducted in the last 7 years. Only open-access articles were selected. To analyze the chosen articles and assess their quality, the criteria of the PRISMA and CASPe statements were applied. All authors participated in both the selection of the articles and their analysis. Results. Of the initial 58 articles selected, a total of 10 articles were fnally included, as they met the eligibility criteria established after further analysis. Te results show a positive relationship between the advanced practice nurse intervention and quality of life in older adults with cancer. Conclusions. Advanced practice nurse (APN) plays a key role in the care of older adults with cancer, signifcantly improving their quality of life and contributing to the comprehensive care of these patients. Te fndings evidenced in this work support the integration of APNs in cancer care teams to improve patient experience and overall well-being.
- Medication adherence in adults with chronic diseases in primary healthcare: a quality improvement projectPublication . Oliveira, Claúdia Jorge; José, Helena Maria Guerreiro; da Costa, EmiliaMedication adherence is influenced by a variety of intricate factors, presenting hurdles for nurses working to improve it among adults with chronic conditions. Pinpointing the reasons for non-adherence is crucial for customizing interventions. The objective of this quality improvement project was to improve medication adherence among adults with chronic diseases in primary healthcare by promoting evidence-based practices, identifying barriers and facilitators to compliance, and developing strategies to ensure optimal adherence through engaging the nursing team, enhancing knowledge, and evaluating the effectiveness of the implemented strategies. (2) Methods: This study was a quality improvement project that utilized the JBI Evidence Implementation framework, the Practical Application of Clinical Evidence System, and the Getting Research into Practice audit tool across three phases: (i) forming a project team and conducting a baseline audit, (ii) offering feedback via the GRiP tool, and (iii) conducting a follow-up audit to assess best practice outcomes. The study was conducted between September 2021 and March 2022 in the community care unit of Algarve Regional Health Administration, targeting adults with chronic illnesses. (3) Results: A total of 148 individuals were audited, including 8 nurses, 70 baseline patients, and 70 post-implementation patients. Initial compliance with key best practices was low, with several criteria at 0% compliance at baseline. Post-intervention, we observed significant improvements; compliance with key best practices improved dramatically, with many reaching 100%. Notable improvements included enhanced patient education on medication management, regular medication adherence assessments, and increased engagement of healthcare professionals in adherence activities. (4) Conclusions: This quality improvement project demonstrated that structured, evidence-based interventions could significantly enhance medication adherence among adults with chronic diseases. The success of the project highlights the potential of similar strategies to be applied broadly in primary healthcare settings to improve health outcomes.
- Characterization of the knee joint phenotype in the Portuguese populationPublication . Seica, Emanuel Cortesao de; Armada, Lucas; Marreiros, Ana; de Almeida Fontes, Ana Paula; Carvalho, Maria Miguel; Sousa, João PauloBackground: Neutral constitutional alignment and neutral joint line obliquity has been the standard alignment strategy for total knee arthroplasty. This one-for-all measure may negatively impact gait pattern and knee biomechanics. Novel alignment strategies surged, considering the variability in phenotypes found across the literature, as different populations may present different phenotype distributions. The Portuguese population has a distinct genetic origin, with no phenotype distribution data. Our objective was to characterise the population’s knee morphology, searching and analysing adjacent joint osteoarthrosis, and calculating the pre-disease coronal alignment. Methods: A retrospective cohort study was conducted. Full-length X-rays performed between 2016-2023 were analysed. Five alignment parameters were measured (LDFA, MPTA, JLCA, TJLA, HKA), and two parameters were calculated (aHKA, JLO). Knees were classified according to the CPAK classification. Results: For the arthritic cohort, CPAK-I (23%) II (20%) were most common, aHKA increases as KL increases (r=0.8352; p<0.001). For the healthy, Type-II (42%) and Type-I (15%) were most common. For paediatric, Type-II (43%) and Type-V (21%) were most common. CPAK Types-VII/VIII/IX were rare. Differences between genders for healthy and arthritic cohorts were statistically significant. The arthritic had higher prevalence of adjacent joint osteoarthritis. Conclusions: The Portuguese population presents a similar knee phenotype comparing with other populations, some differences have been found regarding the Asian continent. The most common phenotype was a neutral alignment if either healthy or paediatric, or a varus alignment if knee OA. Coronal alignment may not have a major impact in the prevalence of ankle and hip osteoarthritis; however, higher prevalence is observed in patients with knee OA.
- Does patient-specific instrumentation in primary total knee arthroplasty improve long-term satisfaction or function? A randomized trial with a 9-year follow-upPublication . Caldeira-Dantas, Sofia; Gonçalves, Marta; Vaz-Pinto, Gonçalo; Dias, Pedro; Marreiros, Ana; de Almeida Fontes, Ana Paula; Sousa, João P.Background: Patient-specific instrumentation (PSI) aims to increase the accuracy of total knee arthroplasty (TKA). However, the long-term benefit compared to conventional instrumentation (CI), is still controversial. This randomized controlled trial compares the long-term outcomes between PSI and CI in TKA. Methods: Patients submitted to PSI or CI TKA with a minimum follow-up of 8 years were evaluated. Satisfaction levels, forgotten joint score (FJS) and Western Ontario and McMaster university osteoarthritis index (WOMAC) scores were compared. Regarding descriptive statistics, mean, standard deviation and frequencies were obtained. For inferential statistics we used the t test for independent samples the Mann-Whitney test and the Wilcoxon Test. Results: A total of 50 TKA were included (48% CI; 52% PSI) with an average follow-up time of 9.3 years. At the final follow-up the WOMAC score was similar between groups (p=0.846; CI:26.8±22.5; PSI:26.8±25.3). Similarly, no differences were seen for the FJS (p=0.785; CI:59.6±35.1; PSI:57.1±36.2) or satisfaction (p=0.486; CI:8.1±2.8; PSI:9.1±1.4). However, at the final follow-up, the total WOMAC score had worse results when compared to the previous evaluations (p=0.013 for CI group; p=0.009 for PSI group). No significant differences in the satisfaction levels were detected regarding the initial and final evaluations (p=0.581 for CI group; p=0.936 for PSI group). Conclusions: Nine years after TKA, PSI and CI patients reported similar levels of satisfaction and functioning. Both groups achieved similar results concerning the WOMAC, FJS scores and satisfaction levels. This study suggests that long-term satisfaction and functioning levels are similar in both PSI and CI.
- Errors in the administration of single-dose dry powder inhalers in patients with chronic bstructive pulmonary disease (COPD)Publication . FARIA FURTADO CINTRA, RUI MIGUEL; de Almeida Fontes, Ana PaulaChecking the effect of a therapeutic education program on the number of errors during the use of two single-dose dry powder inhalers in patients with chronic obstructive pulmonary disease and whether there are differences in the number and type of errors in inhalation technique after an education session, between the Aerolizer® and Handihaler® inhalers, validated using a specific checklist. The sample included 24 users, 17 men and 7 women, with an average age of 68 ± 11 years. It was found, for all the usual significance levels, that the education program contributed to a reduction in errors in administration procedures.
- Navigating perceived stress: experiences of nursing students completing internships during the COVID-19 Pandemic in SpainPublication . Merino-Godoy, María-Ángeles; Aceijas, Zaida Montero; Martín, María Cano; Gago-Valiente, Francisco-Javier; Abengozar, lberto Vega; Padilla, Juan María Pérez; da Costa, EmiliaUniversity students often experience psychological strains such as academic stress, particularly as they approach the transition into the workforce. This stress may have been heightened for nursing students who completed internships during the COVID-19 pandemic. This study aims to analyze the impact of the COVID-19 pandemic on the perceived stress levels of undergraduate nursing students. Methodology: A cross-sectional descriptive observational study was conducted using the Spanish version of the PSS-10 scale, a validated reduction of the English version PSS-14, to evaluate perceived stress. The responses are Likert-type with a total score range of 0 to 40. Questionnaires were distributed electronically to nursing students across all academic years who were engaged in clinical practice. Participation was voluntary. Results: The study included 487 students, the majority of whom were women (78.4%) with an average age of 23.51 years. Most participants were in their third and fourth years (67%). The mean perceived stress score was 20.65 (SD = 5.62) out of a possible 40, indicating moderate stress levels. Statistically significant differences in perceived stress were found between genders, with women reporting higher stress levels than men (Mann-Whitney U = 15,380.000; p < 0.001). Additionally, a significant correlation was observed between the overall perceived stress score and gender, as well as between specific items on the PSS-10 scale and gender, highlighting the importance of gender-specific stress management interventions. Conclusions: Nursing students reported moderate levels of perceived stress, with women experiencing higher stress levels than men. These findings highlight the need for targeted stress management interventions for nursing students, especially during health crises. Addressing gender-specific stressors and fostering a supportive educational environment will enhance students' well-being, academic success, and professional preparedness.
- Pre-hospital ultrasonography screening for biliary disease in remote settingsPublication . Miravent, Sérgio; Jimenez, Cármen; Lobo, Manuel; Figueiredo, Teresa; Almeida, RuiScreening ultrasound, including Point of Care Ultrasonography (POCUS), is widely utilized for rapid clinical guidance in diverse healthcare settings. In this case report, a 34-year-old male with recurrent biliary colic symptoms underwent a Basic Emergency Service ultrasound, revealing a 13 mm gallbladder calculus and signs of inflammation, and was promptly referred to the hospital for further evaluation and treatment. Medical specialist confirmation at the hospital underscored the significance of early detection through POCUS. Despite inconclusive laboratory results, the detailed ultrasound assessment provided a comprehensive understanding, emphasizing the tool's value in averting complications. Thus, screening ultrasound played a pivotal role in justifying the hospital referral, showcasing its vital role in healthcare, especially in resource-limited settings. The judicious use of POCUS can lead to superior outcomes, avoiding unnecessary referrals for non-emergent cases.
- Identification of candidate causal variants and target genes at 41 breast cancer risk loci through differential allelic expression analysisPublication . Gonçalves de Gouveia Maia Xavier, Joana; Magno, Ramiro; Russell, Roslin; Almeida, Bernardo P. de; Jacinta-Fernandes, Ana; Duarte, André; Besouro-Duarte, André; Dunning, Mark; Samarajiwa, Shamith; O’Reilly, Martin; MARQUES MAIA DE ALMEIDA, JOSE ANTONIO; Rocha, Cátia L.; Rosli, Nordiana; Ponder, Bruce A. J.; Maia, Ana-TeresaUnderstanding breast cancer genetic risk relies on identifying causal variants and candidate target genes in risk loci identified by genome-wide association studies (GWAS), which remains challenging. Since most loci fall in active gene regulatory regions, we developed a novel approach facilitated by pinpointing the variants with greater regulatory potential in the disease’s tissue of origin. Through genome-wide differential allelic expression (DAE) analysis, using microarray data from 64 normal breast tissue samples, we mapped the variants associated with DAE (daeQTLs). Then, we intersected these with GWAS data to reveal candidate risk regulatory variants and analysed their cis-acting regulatory potential. Finally, we validated our approach by extensive functional analysis of the 5q14.1 breast cancer risk locus. We observed widespread gene expression regulation by cis-acting variants in breast tissue, with 65% of coding and noncoding expressed genes displaying DAE (daeGenes). We identified over 54 K daeQTLs for 6761 (26%) daeGenes, including 385 daeGenes harbouring variants previously associated with BC risk. We found 1431 daeQTLs mapped to 93 different loci in strong linkage disequilibrium with risk-associated variants (risk-daeQTLs), suggesting a link between risk-causing variants and cis-regulation. There were 122 risk-daeQTL with stronger cis-acting potential in active regulatory regions with protein binding evidence. These variants mapped to 41 risk loci, of which 29 had no previous report of target genes and were candidates for regulating the expression levels of 65 genes. As validation, we identified and functionally characterised five candidate causal variants at the 5q14.1 risk locus targeting the ATG10 and ATP6AP1L genes, likely acting via modulation of alternative transcription and transcription factor binding. Our study demonstrates the power of DAE analysis and daeQTL mapping to identify causal regulatory variants and target genes at breast cancer risk loci, including those with complex regulatory landscapes. It additionally provides a genome-wide resource of variants associated with DAE for future functional studies.
- Ultrasonographic evaluation of the Patellar Tendon in cyclists, volleyball players, and non-practitioners of sports—The influence of gender, age, height, dominant limb, and level of physical activityPublication . Pissarra, Ângela; Ribeiro, Luís Pedro; do Espírito Santo Rodrigues, Sónia IsabelThis study was based on the ultrasound evaluation of the patellar tendon dimensions in the anteroposterior and transversal approaches in sports practitioners (cyclists and volleyball players) and non-sports practitioners. Relationships between the patellar tendon length, width, and thickness with gender, age, height, the dominant limb, and level of physical activity were evaluated. The samples included cyclists, volleyball players, and non-sports practitioners between 15 and 25 years old. Individuals were positioned supine with 30 degrees of knee flexion for bilateral measurements. Sports practitioners presented with an increased patellar tendon length and thickness. There were significant differences bilaterally between sports and non-sports practitioners (p < 0.003). The three dimensions of the patellar tendon of both limbs presented correlations with the male gender (0.336 < r < 0.601), and values of moderate-to-strong intensity in the length of the patellar tendon was directly proportional to height (0.520 < r < 0.601). There was a significant difference between the patellar tendon width and age (p < 0.025). Regarding the level of physical activity, significant differences were found between low and high levels in the three dimensions bilaterally (p < 0.004). The study results indicate that gender, age, height, and level of physical activity impact patellar tendon dimensions. However, there are no associations with the dominant limb.