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- Equilíbrio e risco de queda na pessoa idosa na comunidade – desenho colaborativo e validação de um jogo analógico na abordagem em fisioterapiaPublication . Tome, Ana Maria; Rosa, Marlene; Pais, Sandra; Tomás, Teresa; de Almeida Fontes, Ana PaulaO envelhecimento associa-se a declínio multissistémico das funções físicas, psicológicas, cognitivas e mentais, com destaque para a multimorbilidade, fragilidade, perda de equilíbrio e aumento do risco de queda. O exercício físico mostra evidência na prevenção desse declínio, mas nem todas as pessoas idosas se adaptam. O jogo sério, evidencia-se nos últimos anos como uma intervenção multifatorial potencialmente eficaz nesse declínio. Pretende-se, codesenvolver e explorar o efeito de uma intervenção multifatorial com mecânicas e elementos de jogo analógico, na performance relacionada com o equilíbrio e risco de queda, na pessoa, com 65 ou mais anos de idade na comunidade. Trata-se do segundo estudo - exploratório de codesign de jogo analógico com grupo focal - de um conjunto de quatro, incluídos num projeto de investigação, envolvendo indivíduos idosos da comunidade, inscritos em Universidades Sénior da Região do Algarve. Espera-se um contributo para a evidência científica (participada), de uma estratégia de intervenção para o equilíbrio e risco de queda, baseada no jogo. Conhecer as características da população alvo permitirá planificar adequadamente intervenções e estudos subsequentes. A utilização de uma metodologia com grupo focal possibilita obter informação qualitativa com envolvimento direto dos diferentes interessados. A cocriação, representa um valor acrescentado para a investigação e sucesso de utilização do jogo, permitindo capacitar e potenciar o envolvimento dos utilizadores. O estudo piloto, coadjuvará o desenho do estudo de intervenção, com o qual se espera contribuir para evidenciar um novo protocolo de intervenção com recurso ao jogo analógico, que será testado no estudo experimental.
- + Equilíbrio 65 - risco de queda em idosos na comunidade da região do algarvePublication . Tome, Ana Maria; Rosa, Marlene Cristina Neves; Pais, Sandra Cristina Cozinheiro Fidalgo Rafael Gamboa; Tomás, Maria Teresa Barreiros Caetano; de Almeida Fontes, Ana PaulaIntrodução - As quedas constituem uma das principais causas de morbilidade na população sénior. A identificação e caracterização dos fatores causais é basilar na intervenção. Objetivo - Caracterizar a população de indivíduos com 65 anos ou mais de idade, da comunidade, inscritos em universidades sénior, do ponto de vista sociodemográfico e dos fatores de risco e risco de queda. Metodologia –Estudo transversal observacional. Incluídos indivíduos com 65 ou mais anos de idade. Dados recolhidos por questionário de autopreenchimento e avaliação de risco de queda e capacidade funcional e cognitiva com instrumentos específicos: FES-I TUG-C, FRT e FAB. Resultados – Avaliados 128 participantes dos 65-92 anos de idade (74.95±6.13), 74.2% mulheres. 31,3% tem história de queda no último ano; 75% toma mais de um medicamento por dia; 97,7% refere comorbilidades crónicas; 14.8% e 13.3% apresentam TUG-C e FRT, respetivamente, compatíveis com risco muito elevado de queda. 74,2% tem medo de cair moderado ou elevado e 49,2% tem disfunção marcada das funções executivas Discussão – A elevada percentagem de fatores de risco, a prevalência de quedas anteriores, polimedicação, comorbilidades crónicas e baixo nível de atividade física, risco psicossocial e baixos níveis de escolaridade são sinais de risco. O elevado medo de cair, desempenho reduzido nos testes de equilíbrio estático e dinâmico e o declínio cognitivo evidenciam a importância de uma avaliação multidimensional do risco de queda. Conclusão – Este estudo permitiu um olhar mais consistente sobre a problemática do equilíbrio e risco de queda e possibilitou sinalizar e analisar os principais fatores de risco de queda, em idosos na comunidade numa região do Algarve.
- Physiotherapy management following surgical neurolysis for a peroneal nerve injury: A case reportPublication . Almeida, Pedro Sérgio Costa da Silva; Tome, Ana Maria; Felicio, João Carlos Martins; de Almeida Fontes, Ana PaulaThe peroneal nerve becomes superficial near the head of the fibula, increasing its exposure to injury mechanisms. There is a need to improve knowledge on the influence of physiotherapy on peripheral nerve injury rehabilitation. The case involves a woman with 47 years who suffered a cut in the region of distal third of right common peroneal nerve. This injury resulted in the loss of sensitivity, strength, foot drop, and neuropathic pain after suturing. These symptoms persisted for six weeks, and she had to undergo surgery six weeks after the accident. Physiotherapy was initiated 1 month after the surgical intervention, incorporating manual therapy, electrical stimulation, functional and aerobic exercise, and patient education. The patient experienced sensory alterations, pain was eliminated, and functional recovery of gait and running was achieved. However, there were residual weaknesses in hallux extensor and dorsiflexors. This case study contributes to the development of peroneal nerve rehabilitation interventions.
- Immunomodulatory inhibition of osteoclastogenesis by a marine microalgal ethanol fraction targeting T-cells, antigen presentation, and macrophage fatePublication . Carletti, Alessio; Pes, Katia; Tarasco, Marco; Rosa, Joana; Poudel, Sunil; Pereira, Hugo; Louro, Bruno; Cancela, M. Leonor; Laizé, Vincent; Gavaia, PauloBackground: Targeting immune pathways to prevent bone loss represents a promising, yet underexplored therapeutic strategy. Methods: An ethanol-soluble fraction derived from the freeze-dried biomass of the marine microalga Skeletonema costatum (SKLT) was tested for its ability to modulate immune responses and inhibit osteoclastogenesis. Its effects were evaluated in a zebrafish model of bone regeneration, a medaka model of RANKLinduced osteoporosis, and in vitro using murine RAW 264.7 macrophages. Transcriptomic profiling of regenerating fin blastemas at 24 hours postamputation was performed to identify the affected molecular pathways. Results: In zebrafish, SKLT treatment suppressed the recruitment of osteoclast precursors and altered mineralization dynamics. Transcriptomic profiling revealed downregulation of genes involved in inflammation, antigen presentation, T-cell activation, and macrophage commitment towards osteoclastogenesis, accompanied by reduced expression of chemokines and cytokines that promote osteoclast precursor recruitment and fusion. In medaka, SKLT significantly reduced vertebral bone loss and enhanced neural arch mineralization in larvae with high RANKL expression. In vitro, SKLT inhibited proliferation and osteoclastic differentiation of murine RAW 264.7 macrophages exposed to RANKL without inducing cytotoxicity. Conclusion: These findings identify S. costatum as a source of bioactive immunomodulatory compounds capable of interfering with key osteoimmune mechanisms. Beyond providing proof of concept for their therapeutic potential in bone erosive disorders, this work opens avenues for isolating and characterizing the active molecules, optimizing their delivery, and evaluating their efficacy in preclinical mammalian models. Such strategies could expand the repertoire of safe, nutraceutical-based or adjuvant therapies for osteoporosis and other inflammation-driven skeletal diseases, complementing and potentially enhancing current antiresorptive and anabolic treatments.
- The vertebral column of flatfish: a reviewPublication . Azevedo, A. M. de; Losada, A. P.; Vázquez, S.; Witten, P. E.; Quiroga, M. I.; Gavaia, PauloFlatfish (Pleuronectiformes) encompass fascinating fish species known for their high gastronomical value, rearing performances, and market prices, which attract both economic and scientific interest. Despite these attributes, flatfish exhibit unique morphological, developmental, and biological features, as well as distinctive swimming movements, which require special approaches in skeletal biology research, an area that remains relatively unexplored for this diverse group of fishes. These unique features emerge during metamorphosis, at the end of the larval period, when bilateral symmetric pelagic larvae gradually become asymmetric and undergo various morphological and physiological changes. Consequently, the skeletal characteristics of these species include a certain degree of asymmetry in the skeletal structures. These fish also present acellular bone (bone devoid of osteocytes). Research on flatfish skeletons is crucial for improving animal welfare and promoting sustainable farming, as the literature indicates that more than 50% of the larvae and juveniles of different cultured flatfish can be affected by skeletal deformities. This review aims to compile the available studies on the development of vertebral column deformities in flatfish in an integrative manner, addressing state-of-the-art research on the etiology, diagnostics, and innovative studies on this issue. It also covers the fundamental aspects of teleost skeletal development, particularly the flatfish vertebral column.
- Point-of-care ultrasound for the early detection of intrahepatic biliary tract dilatation: a local study in a basic emergency servicePublication . Miravent, Sérgio; Vaz, Bruna; Lobo, Manuel Duarte; Jimenez, Cármen; Pablo, Pedro; Figueiredo, Teresa; Barbancho, Narciso; Ventura, Miguel; Almeida, RuiBackground/Objectives: Ultrasonography is a diagnostic modality characterized by high sensitivity in detecting hepato-biliary pathology, particularly intrahepatic biliary duct dilation. This study compares the sonographic findings obtained by a radiographer/sonographer in a Basic Emergency Service (BES) using Point-of-Care Ultrasonography (POCUS) in Portugal with the sonographic findings from the same patients acquired by radiologists at a referral hospital (RH) for suspected intrahepatic biliary dilatation. Methods: Nineteen patients presenting with right upper quadrant (RUQ) pain and suspected abdominal pathology underwent sonographic screening using POCUS in the BES. Subsequently, the same patients were referred to the RH, where a radiologist performed a comprehensive ultrasound. Both examinations were compared to determine whether the findings obtained in the BES were confirmed by radiologists in the RH. Results: Cholestasis, cholangitis, lithiasis, pancreatitis, peri-ampullary lithiasis, and neoplasms were observed in association with intrahepatic biliary dilation in this study sample. All six variables showed a strong association between the BES and RH findings (Cramer’s V > 0.6; p < 0.006). A strong kappa measure of agreement between the radiographer and radiologist findings was obtained in “cholelithiasis/sludge/gallbladder acute sonographic changes” (k = 0.802; p = 0.000). A moderate kappa value was obtained for the variable “abdominal free fluid”, (k = 0.706; p = 0.001). Conclusions: In this study, all patients referred from the BES to the RH required hospitalization for treatment and additional imaging exams. Although prehospital screening ultrasound is not intended for definitive diagnoses, the early detection of intrahepatic biliary tract dilatation through screening sonography played a significant role in the clinical referral of patients, with a sensitivity of 94% and specificity of 75%.
- The muscle cells in pelvic floor dysfunctions: systematic reviewPublication . Vieira, Ana Margarida Duarte da Silva; Faleiro, Maria Leonor; Mascarenhas-Saraiva, Miguel; Pais, Sandraackground/Aims: The pelvic floor muscles are important structures involved in pelvic floor tone, pelvic organ support, and continence. The aim of this study was to perform an update on the pelvic floor muscle structure and function alterations of women with pelvic floor dysfunctions. Methods: A systematic search was undertaken in two electronic databases, PubMed/Medline and Ovid Discovery to find manuscripts (in English), published between 1 January 2002 and 31 July 2022, including all clinical studies using the following search terms: “muscle” or “extracellular matrix *” and “pelvic floor dysfunction *”. All clinical trials, observational, or animal studies examining the muscle and reporting pelvic floor dysfunction as a primary outcome were included. Case reports, literature reviews, conference papers and theses, and unpublished data were excluded. To ensure that no eligible articles were overlooked, the reference lists of all included papers underwent manual scrutiny. The bias level was estimated using Newcastle–Ottawa Scale (NOS) for cohort and case-control studies. A qualitative synthesis was performed. Results: The significant qualitative and quantitative heterogeneity between the studies did not allow for a quantitative analysis. Of the 30 articles selected with a total of 5592 women, 15 referred to the analysis of structural muscle defects, which included 3365 participants with urinary incontinence, pelvic organ prolapse, fecal incontinence, cistocele, rectocele, and sexual dysfunction; 10 manuscripts referred to the study of pelvic floor muscle function with a population of 2042 women, such as urinary incontinence, pelvic organ prolapse, fecal incontinence, and sexual dysfunction; and 5 papers evaluated cellular and/or molecular changes affecting the pelvic floor muscles, like urinary incontinence, pelvic organ prolapse, and rectocele, which included a total of 185 participants. Women with pelvic floor muscle defects are at greater risk of pelvic floor dysfunctions, and inversely, women with pelvic floor dysfunctions have more pelvic floor muscle defects than women without pelvic floor dysfunctions. These patients demonstrate a reduction in muscle tone, contraction strength, and resistance, a compromised neuromuscular activity, and an alteration of the normal composition and organization of the muscle cells. Conclusions: Women with pelvic floor dysfunction have anatomical muscle defects, disturbance of muscle function and cellular changes involving muscle cells and nerve fibers.
- Comparing the diagnostic performance of ultrasound elastography and magnetic resonance imaging to differentiate benign and malignant breast lesions: a systematic review and meta-analysisPublication . Gomes, Ana Filipa; Justino, David; Tomás, Carina; Jesus, Diogo; Macedo, Ana; Pinto, Ezequiel; Leitao, HelenaObjective: The purpose of this systematic review and meta-analysis was comparing diagnostic performance of ultrasound elastography (UE), strain UE and shear wave elastography (SWE), with magnetic resonance imaging (MRI) in differentiating benign and malignant breast lesions. Methods: Literature search of MEDLINE, Web of Science, SCOPUS and Google Scholar was performed in June 2023. Included studies used Breast Imaging Reporting and Data System (BI-RADS) and histopathology as reference standard. A bivariate random-effects model was used to calculate sensitivity, specificity, diagnostic odds ratio (DOR), positive and negative likelihood ratios and area under the curve (AUC). Meta-regression subgroup analysis was performed. Results: Nine studies and 536 lesions were included. Pooled sensitivity was not different between MRI vs UE [MRI: 94% (95% CI: 88.2%-96.9%) vs UE: 90% (95% CI: 84.7%-93.1%); P=0.153] but a difference was found for specificity [UE: 78% (95% CI: 66.3%-86.4%) vs MRI: 71.3% (95% CI: 52.1%-85%); P=0.0065]. Strain UE showed higher specificity and similar sensitivity to SWE [strain UE: 0.85 (95% CI: 0.71-0.93) vs SWE: 0.72 (95% 0.58-0.83); P=0.017 and strain UE: 0.87 (95% CI 0.79-0.93) vs SWE: 0.91 (95% CI 0.85-0.95); P=0.311, respectively]. AUC was similar between MRI vs UE [0.91 (95% CI 0.87-0.95) vs 0.92 (95% CI 0.88-0.95); P=0.452, respectively] as was DOR [MRI: 38.083 (95% CI: 12.401-116.957) vs UE: 30.395 (95% CI: 16.572-55.75); P > 0.05]. Meta-regression analysis found no significant differences in the diagnostic accuracy between MRI, strain UE and SWE. Conclusion: Our results show that UE when compared to MRI has adequate performance in differentiating benign and malignant breast lesions.
- Analysis of TERT association with clinical outcome in meningiomas: a multi-institutional cohort study.Publication . Gui, Chloe; Wang, Justin Z.; Patil, Vikas; Landry, Alexander P.; Castelo-Branco, Pedro; Singh, Olivia; Tabori, Uri; Aldape, Kenneth; Behling, Felix; Barnholtz-Sloan, Jill S.; Horbinski, Craig; Tabatabai, Ghazaleh; Ajisebutu, Andrew; Liu, Jeff; Patel, Zeel; Yakubov, Rebeca; Kaloti, Ramneet; Ellenbogen, Yosef; Wilson, Christopher; Cohen-Gadol, Aaron; Tatagiba, Marcos; Holland, Eric C.; Sloan, Andrew E.; Chotai, Silky; Chambless, Lola B.; Gao, Andrew; Makarenko, Serge; Yip, Stephen; Nassiri, Farshad; Zadeh, GelarehBackground TERT promoter mutation is a rare biomarker in meningiomas associated with aberrant TERT expression and reduced progression-free survival. Although high TERT expression is characteristic of tumours with TERT promoter mutations, it has also been observed in tumours with wildtype TERT promoters. This study aimed to investigate the prevalence and prognostic association of TERT expression in meningiomas.
- Association of acute COVID-19 severity and long COVID fatigue and quality of life: prospective cohort multicenter observational studyPublication . Pires, Ligia; Marreiros, Ana; Saraiva, Cátia; Reis, Cláudia; Neves, Djamila; Guerreiro, Cláudia; Tomé, José Boleo; Luz, Maria Inês; Pereira, Margarida Isabel; Barroso, Ana Sofia; Ferreira, Jorge; Gonzalez, Lucía Méndez; Moniri, Armin; Drummond, Marta; Berger-Estilita, JoanaLong COVID, or post-COVID-19 condition, is characterized by symptoms persisting beyond 12 weeks after severe acute respiratory syndrome coronavirus 2 infection, affecting individuals regardless of acute disease severity. Fatigue – often linked with depression and anxiety – is among its most debilitating manifestations. However, the associations between fatigue subtypes (physical vs mental), mental health symptoms, and acute disease severity on long-term health-related quality of life (HRQoL) remain unclear. This study examines the relationships between long COVID fatigue, depression, anxiety, acute disease severity, and HRQoL in a post-COVID-19 cohort. This prospective observational cohort study was conducted across 5 Portuguese hospitals between November 2020 and June 2022. Adults (≥18 years) with confirmed severe acute respiratory syndrome coronavirus 2 infection ≥6 months prior and fulfilling World Health Organization criteria for long COVID were included. Acute Coronavirus disease 2019 (COVID-19) severity was classified per World Health Organization definitions. The sampling strategy included patients across the severity spectrum. At 3 months postinfection (T1), patients received physician-led clinical assessments. At 6 months (T2), they attended in-person follow-up visits, completing standardized forms and validated questionnaires assessing post-acute sequelae. Fatigue was reported both binarily (yes/no) and via the chalder fatigue scale (11-item version). Anxiety and depression were assessed using the hospital anxiety and depression scale; post-traumatic stress disorder symptoms with the 14-item post-traumatic stress scale; and HRQoL with the EuroQol-5 dimensions. Descriptive statistics, analysis of variance, chi-square, and correlation analyses (Pearson’s or Spearman’s) were used to evaluate associations. Analyses were performed using SPSS (v27; IBM Corp., Amonk). Among 208 patients, fatigue was significantly associated with anxiety and depression (P < .001). Physical fatigue correlated more strongly with depression (r = 0.65, P < .001) and anxiety (r = 0.58, P < .001) than mental fatigue (r = 0.50 and R = 0.48, respectively; P < .001). Surprisingly, severe acute COVID-19 cases reported lower fatigue (CFQ: 13.3 ± 8.4) than mild (17.7 ± 7.2) or moderate (17.4 ± 8.0) cases (P < .005), and higher HRQoL (EuroQol visual analog scale: 74.3 ± 20.3, P = .002). Anxiety symptoms were more common in mild cases (P < .001); post-traumatic stress disorder symptoms did not differ by severity. Long COVID fatigue – especially physical – is strongly linked to depression and anxiety. Mild/moderate acute COVID-19 cases show greater fatigue and lower HRQoL than severe cases, highlighting the need for tailored long-term care regardless of initial severity.