Browsing by Author "Santos, Teresa"
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- Bioelectrical Impedance Analysis (BIA) for the assessment of body composition in oncology: a scoping reviewPublication . Branco, Mariana Garcia; Mateus, Carlota; Capelas, Manuel Luís; Pimenta, Nuno; Santos, Teresa; Mäkitie, Antti; Ganhão-Arranhado, Susana; Trabulo, Carolina; Ravasco, PaulaBioelectrical Impedance Analysis (BIA) is a reliable, non-invasive, objective, and cost-effective body composition assessment method, with high reproducibility. This scoping review aims to evaluate the current scientific and clinical evidence on BIA for body composition assessment in oncology patients, under active treatment. Literature search was conducted through MEDLINE, CINAHL, Scopus and Web of Science databases, following PRISMA-ScR Guidelines. Inclusion criteria comprised studies reporting the use of BIA for body composition evaluation in adults with cancer diagnosis. Studies including non-cancer pathology or only assessing nutritional status were excluded. This scoping review comprised a total of 36 studies: 25 were original studies including 18 prospective studies, six cross-sectional studies and one retrospective study and 11 were systematic reviews. Population size for the included original articles ranged from 18 to 1217 participants, comprising a total of 3015 patients with cancer with a mean baseline Body Mass Index (BMI) ranging from 20.3 to 30.0 kg/m2 and mean age ranging between 47 and 70 years. Review articles included a total of 273 studies, with a total of 78,350 participants. The current review considered studies reporting patients with head and neck cancer (HNC) (n = 8), breast cancer (BC) (n = 4), esophageal cancer (EC) (n = 2), liver cancer (n = 2), pancreatic cancer (PC) (n = 3), gastric cancer (GC) (n = 3), colorectal cancer (CRC) (n = 8), lung cancer (LC) (n = 1), skin cancer (SK) (n = 1) and multiple cancer types (n = 6). BIA is a suitable and valid method for the assessment of body composition in oncology. BIA-derived measures have shown good potential and relevant clinical value in preoperative risk evaluation, in the reduction of postoperative complications and hospital stay and as an important prognostic indicator in persons with cancer. Future research on the diagnostic value and clinical applications of BIA and BIA-derived phase angle (PhA) should be conducted in order to predict its impact on patient survival and other clinical outcomes.
- Dairy products: is there an impact on promotion of prostate cancer? A review of the literaturePublication . Vasconcelos, Alexandra; Santos, Teresa; Ravasco, Paula; Neves, Pedro MiguelThis review of the literature aims to study potential associations between high consumption of milk and/or dairy products and prostate cancer (PC). Literature is scarce, yet there is a direct relationship between mTORC1 activation and PC; several ingredients in milk/dairy products, when in high concentrations, increase signaling of the mTORC1 pathway. However, there are no studies showing an unequivocal relationship between milk products PC initiation and/or progression. Three different reviews were conducted with articles published in the last 5 years: (M1) PC and intake of dairy products, taking into account the possible mTORC1signaling mechanism; (M2) Intake of milk products and incidence/promotion of PC; (M3) mTORC1 activation signaling pathway, levels of IGF-1 and PC; (M4) mTORC pathway and dairy products. Of the 32 reviews identified, only 21 met the inclusion criteria and were analyzed. There is little scientific evidence that directly link the three factors: incidence/promotion of PC, intake of dairy products and PC, and PC and increased mTORC1 signaling. Persistent hyper-activation of mTORC1 is associated with PC promotion. The activity of exosomal mRNA in cellular communication may lead to different impacts of different types of milk and whether or not mammalian milks will have their own characteristics within each species. Based on this review of the literature, it is possible to establish a relationship between the consumption of milk products and the progression of PC; we also found a possible association with PC initiation, hence it is likely that the intake of dairy products should be reduced or minimized in mens' diet.
- Managing severe dysgeusia and dysosmia in lung cancer patients: a systematic scoping reviewPublication . Spencer, Ana Sofia; Dias, David da Silva; Capelas, Manuel Luís; Pimentel, Francisco; Santos, Teresa; Neves, Pedro Miguel; Mäkitie, Antti; Ravasco, PaulaIntroduction: Lung cancer (LC) is highly prevalent worldwide, with elevated mortality. In this population, taste and smell alterations (TSAs) are frequent but overlooked symptoms. The absence of effective therapeutic strategies and evidence-based guidelines constrain TSAs’ early recognition, prevention and treatment (Tx), promoting cancer-related malnutrition and jeopardizing survival outcomes and quality of life. Objectives: To systematically review the literature on TSAs in LC patients, understand the physiopathology, identify potential preventive and Tx strategies and to further encourage research in this area. Methods: Literature search on English language articles indexed to PubMed, CINALH, SCOPUS and Web of Science using MeSH terms “Lung neoplasms”,”Dysgeusia”, “Olfaction Disorders”, “Carcinoma, Small Cell”,”Carcinoma, Non- Small-Cell Lung “Adenocarcinoma of Lung”,”Carcinoma, Large Cell”, and non-MeSH terms “Parageusia”, “Altered Taste”, “Smell Disorder”, “Paraosmia”, “Dysosmia”,”Lung Cancer” and “Oat Cell Carcinoma”. Results: Thirty-four articles were reviewed. TSAs may follow the diagnosis of LC or develop during cancer Tx. The estimated prevalence of self-reported dysgeusia is 35-38% in treatment-naïve LC patients, and 35-69% in those undergoing Tx, based on studies involving LC patients only. One prospective pilot trial and 1 RCT demonstrated a clinically significant benefit in combining flavor enhancement, smell and taste training and individualized nutritional counselling; a systematic review, 1 RCT and 1 retrospective study favored using intravenous or oral zinc-based solutions (150mg 2-3 times a day) for the prevention and Tx of chemotherapy (CT) and radiotherapy (RT) -induced mucositis and subsequent dysgeusia. Conclusions: This is the first review on dysgeusia and dysosmia in LC patients to our knowledge. We propose combining taste and smell training, personalized dietary counselling and flavor enhancement with oral zinc-based solutions (150mg, 2-3 times a day) during CT and/or RT in this population, in order to prevent and help ameliorate Tx-induced dysgeusia and mucositis. However due to study heterogeneity, the results should be interpreted with caution. Developing standardized TSA measurement tools and performing prospective randomized controlled trials to evaluate their effect are warranted.
- Positive youth development in adolescencePublication . Santos, Teresa
- Quality of maternal and newborn care around the time of childbirth for migrant versus nonmigrant women during the COVID-19 pandemic: results of the IMAgiNE EURO study in 11 countries of the WHO European regionPublication . the IMAgiNE EURO study group; Costa, Raquel; Rodrigues, Carina; Dias, Heloísa; Covi, Benedetta; Mariani, Ilaria; Valente, Emanuelle Pessa; Zaigham, Mehreen; Vik, Eline Skirnisdottir; Grylka-Baeschlin, Susanne; Arendt, Maryse; Santos, Teresa; Wandschneider, Lisa; Drglin, Zalka; Drandić, Daniela; Radetic, Jelena; Rozée, Virginie; Elden, Helen; Mueller, Antonia N.; Barata, Catarina; Miani, Céline; Bohinec, Anja; Ruzicic, Jovana; de La Rochebrochard, Elise; Linden, Karolina; Geremia, Sara; de Labrusse, Claire; Batram-Zantvoort, Stephanie; Ponikvar, Barbara Mihevc; Sacks, Emma; Lazzerini, MarziaObjective: To describe the perception of quality of maternal and newborn care (QMNC) around the time of childbirth among migrant and nonmigrant women in Europe. Methods: Women who gave birth at a health facility in 11 countries of the WHO European Region from March 2020 to July 2021 were invited to answer an online questionnaire including demographics and childbirth experience. Data were analyzed and compared for 1781 migrant and 20 653 nonmigrant women. Results: Migrant women who experienced labor perceived slightly more difficulties in attending routine antenatal visits (41.2% vs 39.4%; P = 0.001), more barriers in accessing facilities (32.9% vs 29.9%; P = 0.001), lack of timely care (14.7% vs 13.0%; P = 0.025), inadequate room comfort and equipment (9.2% vs 8.5%; P = 0.004), inadequate number of women per room (9.4% vs 8.6%; P = 0.039), being prevented from staying with their baby as they wished (7.8% vs 6.9%; P = 0.011), or suffering abuse (14.5% vs 12.7%; P = 0.022) compared with nonmigrant women. For women who had a prelabor cesarean, migrant women were more likely not to receive pain relief after birth (16.8% vs.13.5%; P = 0.039) and less likely to provide informal payment (1.8% vs 4.4%; P = 0.005) compared with nonmigrant women. Overall, the QMNC index was not significantly different for migrant compared with nonmigrant women. Conclusion: Gaps in overall QMNC were reported by both migrant and nonmigrant women, with improvements to healthcare necessary for all.
- Rates of instrumental vaginal birth and cesarean and quality of maternal and newborn health care in private versus public facilities: results of the IMAgiNE EURO study in 16 countriesPublication . IMAgiNE EURO study group; Lazzerini, Marzia; Valente, Emanuelle Pessa; Covi, Benedetta; Rozée, Virginie; Costa, Raquel; Otelea, Marina Ruxandra; Abderhalden-Zellweger, Alessia; Węgrzynowska, Maria; Linden, Karolina; Arendt, Maryse; Brigidi, Serena; Miani, Céline; Pumpure, Elizabete; Radetic, Jelena; Drandic, Daniela; Cerimagic, Amira; Nedberg, Ingvild Hersoug; Liepinaitienė, Alina; Rodrigues, Carina; de Labrusse, Claire; Baranowska, Barbara; Zaigham, Mehreen; Castañeda, Lara Martín; Batram-Zantvoort, Stephanie; Jakovicka, Dārta; Ruzicic, Jovana; Juciūtė, Simona; Santos, Teresa; Gemperle, Michael; Tataj-Puzyna, Urszula; Elden, Helen; Mizgaitienė, Marija; Lincetto, Ornella; Sacks, Emma; Mariani, IlariaObjective: To explore the quality of maternal and newborn care (QMNC) during the COVID-19 pandemic by facility type among 16 European countries, comparing rates of instrumental vaginal birth and cesarean. Methods: Women who gave birth in the WHO European Region from March 1, 2020, to February 7, 2022, answered a validated online questionnaire. Rates of instrumental birth, instrumental vaginal birth, and cesarean, and a QMNC index were calculated for births in public versus private facilities. Results: Responses from 25 206 participants were analyzed. Women giving birth in private compared with public facilities reported significantly more frequent total cesarean (32.5% vs 19.0%; aOR 1.70; 95% CI 1.52–1.90), elective cesarean (17.3% vs 7.8%; aOR 1.90; 95% CI 1.65–2.19), and emergency cesarean before labor (7.4% vs 3.9%; aOR 1.39; 95% CI 1.14–1.70) (P < 0.001 for all comparisons), with analyses by country confirming these results. QMNC index results were heterogeneous across countries and regions in the same country and were largely affected by geographical distribution of regions rather than by type of facility alone. Conclusion: The study confirms that births in private facilities have higher odds of cesarean. It also suggests that QMNC should be closely monitored in all facilities to achieve high-quality care, independent of facility type or geographical distribution. ClinicalTrials.gov Identifier: NCT04847336.
- Regional differences in the quality of maternal and neonatal care during the COVID-19 pandemic in Portugal: results from the IMAgiNE EURO studyPublication . IMAgiNE EURO study group; Costa, Raquel; Barata, Catarina; Dias, Heloísa; Rodrigues, Carina; Santos, Teresa; Mariani, Ilaria; Covi, Benedetta; Valente, Emanuelle Pessa; Lazzerini, Marzia; Ćerimagić, Amira; Drandić, Daniela; Kurbanović, Magdalena; Virginie, Rozée; de La Rochebrochard, Elise; Löfgren, Kristina; Miani, Céline; Batram-Zantvoort, Stephanie; Wandschneider, Lisa; Morano, Sandra; Chertok, Ilana; Hefer, Emek; Artzi-Medvedik, Rada; Pumpure, Elizabete; Rezeberga, Dace; Jansone-Šantare, Gita; Jakovicka, Dārta; Knoka, Anna Regīna; Vilcāne, Katrīna Paula; Liepinaitienė, Alina; Kondrakova, Andželika; Mizgaitienė, Marija; Juciūtė, Simona; Arendt, Maryse; Tasch, Barbara; Nedberg, Ingvild Hersoug; Kongslien, Sigrun; Vik, Eline Skirnisdottir; Baranowska, Barbara; Tataj-Puzyna, Urszula; Węgrzynowska, Maria; Otelea, Marina RuxandraObjective: To compare women's perspectives on the quality of maternal and newborn care (QMNC) around the time of childbirth across Nomenclature of Territorial Units for Statistics 2 (NUTS-II) regions in Portugal during the COVID-19 pandemic. Methods: Women participating in the cross-sectional IMAgiNE EURO study who gave birth in Portugal from March 1, 2020, to October 28, 2021, completed a structured questionnaire with 40 key WHO standards-based quality measures. Four domains of QMNC were assessed: (1) provision of care; (2) experience of care; (3) availability of human and physical resources; and (4) reorganizational changes due to the COVID-19 pandemic. Frequencies for each quality measure within each QMNC domain were computed overall and by region. Results: Out of 1845 participants, one-third (33.7%) had a cesarean. Examples of high-quality care included: low frequencies of lack of early breastfeeding and rooming-in (8.0% and 7.7%, respectively) and informal payment (0.7%); adequate staff professionalism (94.6%); adequate room comfort and equipment (95.2%). However, substandard practices with large heterogeneity across regions were also reported. Among women who experienced labor, the percentage of instrumental vaginal births ranged from 22.3% in the Algarve to 33.5% in Center; among these, fundal pressure ranged from 34.8% in Lisbon to 66.7% in Center. Episiotomy was performed in 39.3% of noninstrumental vaginal births with variations between 31.8% in the North to 59.8% in Center. One in four women reported inadequate breastfeeding support (26.1%, ranging from 19.4% in Algarve to 31.5% in Lisbon). One in five reported no exclusive breastfeeding at discharge (22.1%; 19.5% in Lisbon to 28.2% in Algarve). Conclusion: Urgent actions are needed to harmonize QMNC and reduce inequities across regions in Portugal.
- A systematic review of vitamin D supplementation in oncology: chance of science or effectiveness?Publication . Afonso, Marta Lourenço; Capelas, Manuel Luís; Pimenta, Nuno M.; Santos, Teresa; Mäkitie, Antti; Ganhão-Arranhado, Susana; Trabulo, Carolina; Dias, David da Silva; Neves, Pedro Miguel; Ravasco, PaulaBackground: Vitamin D (VD) supplementation has increased considerably in the last decade, whether for the prevention or treatment of numerous diseases, including bone, cardiovascular, endocrine, neurologic, psychological, respiratory, infectious, or oncological. The primary objective of this scoping review was to examine and synthesize the scientific evidence on the role of VD in all-type cancer patients undergoing adjuvant and neoadjuvant therapy with chemotherapy (CT) or radiotherapy (RT), namely in improving side effects. Methods: This review was conducted by selecting papers from the CINAHL, Scopus and PubMed databases based on the descriptor terms mesh and title/abstract, taking into consideration the defined inclusion and exclusion criteria, following the PRISMA-ScR (PRISMA extension for scoping reviews) statement. Results: A total of 758 papers were identified in different databases during this review. However, using the inclusion and exclusion criteria, only five publications made up the final sample of the study. The studies included heterogeneous study methodologies, objectives, cancer diagnosis, as well as methods to assess body composition, which makes it difficult to compare them. Based on the analyzed studies, associations were found between bone density and VD in patients who underwent preoperative chemoradiotherapy (CRT). In patients with non-small-cell lung cancer receiving CT, some of the side effects associated with the treatment were attenuated and reduced. In addition, another of the studies analyzed found that VD deficiency (VDD) has been associated with increased peripheral neuropathy (PN) induced by CT in the treatment of breast cancer. VD supplementation was found to be safe and effective. Conclusions: In this scoping review, VD is highlighted as a crucial factor in preventing the side effects of neoadjuvant RT or CT, as well as treating other treatmentrelated health conditions, such as osteoporosis, as well as ameliorating the side effects (nausea, vomiting, fatigue) associated with aggressive CT and RT.
- The effect of flaxseed in breast cancer: a literature reviewPublication . Calado, Ana; Neves, Pedro Miguel; Santos, Teresa; Ravasco, PaulaBreast cancer is one of the most common cancers and the second most responsible for cancer mortality worldwide. In 2014, in Portugal approximately 27,200 people died of cancer, of which 1,791 were women with breast cancer. Flaxseed has been one of the most studied foods, regarding possible relations to breast cancer, though mainly in experimental studies in animals, yet in few clinical trials. It is rich in omega-3 fatty acids, α-linolenic acid, lignan, and fibers. One of the main components of flaxseed is the lignans, of which 95% are made of the predominant secoisolariciresinol diglucoside (SDG). SDG is converted into enterolactone and enterodiol, both with antiestrogen activity and structurally similar to estrogen; they can bind to cell receptors, decreasing cell growth. Some studies have shown that the intake of omega-3 fatty acids is related to the reduction of breast cancer risk. In animal studies, α-linolenic acids have been shown to be able to suppress growth, size, and proliferation of cancer cells and also to promote breast cancer cell death. Other animal studies found that the intake of flaxseed combined with tamoxifen can reduce tumor size to a greater extent than taking tamoxifen alone. Additionally, some clinical trials showed that flaxseed can have an important role in decreasing breast cancer risk, mainly in postmenopausal women. Further studies are needed, specifically clinical trials that may demonstrate the potential benefits of flaxseed in breast cancer.
- The impact of pre-, pro- and synbiotics supplementation in colorectal cancer treatment: a systematic reviewPublication . Moreira, Mariana Melo; Carriço, Marta; Capelas, Manuel Luís; Pimenta, Nuno; Santos, Teresa; Ganhao-Arranhado, Susana; Mäkitie, Antti; Ravasco, PaulaIntroduction: The effectiveness of the supplementation of prebiotics, probiotics and synbiotics as a therapeutic approach in colorectal cancer (CRC) remains unclear. The aim of this systematic review is to critically examine the current scientific evidence on the impact of modulating the microbiota, through the use of prebiotics, probiotics and synbiotics, in patients diagnosed with CRC undergoing treatment, to determine the potential therapeutic use of this approach. Methods: This systematic review was made according to the PRISMA 2020 guidelines. Inclusion criteria were randomized controlled trials (RCT) comparing the impact of pre-, pro-, or synbiotic supplementation with placebo or standard care in patients with CRC undergoing treatment. Exclusion criteria were nonhuman studies, non-RCTs, and studies in languages other than English or Portuguese. Six databases were consulted, namely, Cochrane Library, Pubmed, Scopus, Cinahl, MedicLatina and Web of Science until May of 2023. RAYYAN software was used to manage the search results and risk of bias was assessed according to the guidelines of the Cochrane Collaboration using the Rob 2.0 tool. Results: Twenty-four RCTs met the inclusion criteria and were included in this review. Administration of pre-, pro-, or synbiotics improved surgical outcomes such as the incidence of infectious and non-infectious postoperative complications, return to normal gut function, hospital length of stay, and antibiotic usage. The supplementation of these microorganisms also alleviated some symptoms from chemotherapy and radiotherapy, mainly diarrhea. Evidence on the best approach in terms of types of strains, dosage and duration of intervention is still scarce. Conclusions: Pre-, pro-, and synbiotics supplementation appears to be a beneficial therapeutic approach in CRC treatment to improve surgical outcomes and to alleviate side-effects such as treatment toxicity. More RCTs with larger sample sizes and less heterogeneity are needed to confirm these potential benefits and to determine the best strains, dosage, and duration of administration in each situation.