Browsing by Author "Sousa, Diana"
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- As condições de trabalho e o stress ocupacional de profissionais de saúde durante a COVID-19Publication . Sousa, Diana; Sobral, Filipa; Morais, CatarinaEm março de 2020, a Organização Mundial de Saúde declarou a COVID-19 como pandemia. O seu surgimento e propagação contribuiu para aumentar os desafios existentes no quotidiano dos profissionais de saúde, impelindo o desenvolvimento de uma parceria entre o Serviço Nacional de Saúde e Privados para prestar uma resposta otimizada ao tratamento da doença, em Portugal. O stress ocupacional, traduzido no medo e preocupação de ser infetado e infetar, devido às jornadas laborais extensas e falta de materiais e recursos no combate ao vírus, leva a presente investigação a ter como objetivo a análise da perceção das condições de trabalho e dos níveis de stress ocupacional percecionados pelos profissionais de saúde nos contextos hospitalares público e privado durante a pandemia. Tratou-se de um estudo quantitativo e transversal, composto por um total de 97 profissionais de saúde do setor público e privado. Os resultados revelaram que, apesar da média dos valores de sobrecarga horária entre setores ser semelhante, os profissionais de saúde trabalharam significativamente mais horas do que as estipuladas/previstas. De igual modo, o nível de stress ocupacional entre os profissionais dos diferentes contextos foi similar. Por fim, aferiu-se que as condições físicas e materiais de trabalho são preditoras de stress ocupacional, ao invés da sobrecarga horária. Este estudo demonstra que é importante que as instituições de saúde, sejam elas públicas ou privadas, disponibilizem aos seus trabalhadores as melhores condições de trabalho físicas e materiais possíveis, sobretudo face às exigências de um contexto pandémico.
- The differential diagnosis of adrenocortical tumors: systematic review of Ki-67 and IGF2 and meta-analysis of Ki-67Publication . Oliveira, Sofia B.; Machado, Mariana Q.; Sousa, Diana; Pereira, Sofia S.; Pignatelli, DuarteDistinguishing benign from malignant adrenocortical tumors (ACT) is not always easy, particularly for tumors with unclear malignant potential based on the histopathological features comprised of the Weiss score. Previous studies reported the potential utility of immunohistochemistry (IHC) markers to recognize malignancy, in particular the Insulin-like growth factor 2 (IGF2) and the proliferation marker, Ki-67. However, this information was not compiled before. Therefore, this review aimed to collect the evidence on the potential diagnosis utility of IGF2 and Ki-67 IHC staining. Additionally, a meta-analysis was performed to assess the Ki-67 accuracy to identify adrenocortical carcinoma. The systematic review and meta-analysis were conducted according to the PRISMA guidelines. From the 26 articles included in the systematic review, 21 articles provided individual data for IGF2 (n = 2) or for Ki-67 (n = 19), while 5 studies assessed both markers. IGF2 staining was positive in most carcinomas, in contrast to adenomas. However, the different immunostaining evaluation methods adopted among the studies impeded to perform a meta-analysis to assess IGF2 diagnostic accuracy. In contrast, for the most commonly used cut-off value of 5% stained cells, Ki-67 showed pooled specificity, sensitivity and log diagnostic odds ratio of 0.98 (95% CI 0.95 to 0.99), 0.82 (95% CI 0.65 to 0.92) and 4.26 (95% CI 3.40 to 5.12), respectively. At the 5% cut-off, Ki-67 demonstrated an excellent specificity to recognize malignant ACT. However. the moderate sensitivity observed indicates the need for further studies exploring alternative threshold values. Additionally, more studies using similar approaches are needed to assess the diagnostic accuracy of IGF2. Registration code in PROSPERO: CRD42022370389.
- MicroRNA-665 and its potential role in drug response and survival outcomes in multiple myeloma: a preliminary studyPublication . Bergantim, Rui; Silva, Sara Peixoto da; Pinto, Vanessa; Pereira, Joana M.; Sousa, Diana; Trigo, Fernanda; Matthiesen, Rune; Guimarães, José E.; Vasconcelos, M. HelenaBackground: Multiple myeloma (MM) is a complex hematological malignancy with heterogeneous clinical and pathophysiological backgrounds that influence treatment responses and outcomes. Identifying biomarkers to predict drug response and guide treatment decisions, particularly regarding drug combinations, is essential to improve therapeutic efficacy and patient outcomes. This study explores the role of microRNAs (miRNAs/miRs) derived from bone marrow (BM) and peripheral blood (PB) in responses to treatment and survival outcomes in newly diagnosed MM (ndMM) patients. Methods: This study included twenty patients with ndMM undergoing first-line treatment with bortezomib, thalidomide, and dexamethasone. The miRNAs were isolated from BM and PB, and their profiles were analyzed using Next-Generation Sequencing (NGS), followed by validation of differentially expressed miRNAs by quantitative real-time PCR (qPCR). Clinical and response data were collected to assess correlations between miRNA levels, clinical characteristics, and patient outcomes. In silico analysis for target-prediction and gene ontology (GO) enrichment was performed to explore the potential biological and functional role of the identified miRNAs. Results: NGS profiling revealed several miRNAs differently expressed between treatment-refractory and sensitive patients, as well as between PB and BM. Among these, miR-665, miR-483-5p, miR-143-3p and miR-145-5p were selected for further validation by qPCR. It was observed that miR-665 was significantly elevated in treatment-refractory patients compared to treatment-sensitive patients. Additionally, miR-665 levels were higher in PB than in BM. Elevated miR-665 levels were associated with more aggressive disease characteristics and poorer clinical outcomes, including reduced overall survival. Discussion: Our preliminary findings suggest that miR-665 could potentially serve as a non-invasive tool for predicting drug resistance and guiding treatment decisions in MM. These findings also highlight the potential utility of miRNAs in liquid biopsies as a predictive tool of drug response in MM and could pave the way for personalized treatment strategies, improving patient outcomes. Future research is needed to validate these results in larger cohorts and explore the underlying mechanisms of miR-665 in MM pathogenesis and drug resistance.