Browsing by Author "Ventura, Filipa"
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- Alopécia areata: análise retrospectiva da consulta de dermatologia pediátrica (2000-2008)Publication . Rocha, Joana; Ventura, Filipa; Vieira, Ana Paula; Pinheiro, Ana Raquel; Fernandes, Susana; Brito, CelesteIntrodução: A alopécia areata (AA) é um tipo de alopécia não cicatricial, cuja primeira manifestação ocorre antes dos 16 anos em 50% dos casos. Para a maioria dos autores, tem etiologia autoimune mas parecem estar também envolvidos factores genéticos, psicológicos e ambientais. Objectivos: Revisão de aspectos epidemiológicos, clínicos e terapêuticos em doentes com AA e início da doença antes dos 16 anos. Identificar características do funcionamento psicológico dos doentes e relacionar acontecimentos de vida significativos com o aparecimento da doença. Métodos: Estudo descritivo e retrospectivo baseado na consulta de processos clínicos dos doentes com AA seguidos na consulta de Dermatologia Pediátrica do Hospital de São Marcos, entre Janeiro de 2000 e Dezembro de 2008. A quinze destes doentes foram aplicados instrumentos de avaliação psicométrica. Resultados: Neste estudo foram incluídos 48 doentes (54% sexo masculino, 46% sexo feminino). A idade média à data de diagnóstico foi de 7,8 anos. Em 10% dos doentes identificaram-se antecedentes familiares de AA e em 25% verificou-se associação com atopia. A forma limitada da doença foi a mais frequentemente observada (82% dos doentes), tendo tido as formas extensas aparecimento mais precoce. Na doença limitada, a terapêutica mais utilizada foi a corticoterapia tópica (53% dos doentes), registando-se melhoria na maioria dos casos e resolução completa em 54%. Em 71% dos doentes com envolvimento de mais de 50% do couro cabeludo foi instituída terapêutica sistémica (corticoterapia e/ ou ciclosporina). Destes, em apenas um se verificou melhoria sustentada; nos restantes, a evolução foi ondulante. Dos doentes avaliados do ponto de vista psicológico, em 80% identificou-se evento potencialmente traumático a anteceder o aparecimento da primeira manifestação da doença dermatológica. Discussão: A análise dos resultados está de acordo com alguns estudos publicados. No entanto, o tamanho desta série de doentes e a escassez de literatura relativa à AA em idade pediátrica dificultam a comparação dos resultados e definição de protocolos na investigação e tratamento destes doentes. Uma abordagem multidisciplinar será importante dado o impacto da doença no bem-estar destas crianças
- Evidence-informed development of a bundle for peripheral intravenous catheterization in Portugal: a delphi consensus studyPublication . Santos-Costa, Paulo; Paiva-Santos, Filipe; Sousa, Liliana B.; Bernardes, Rafael A.; Ventura, Filipa; Salgueiro-Oliveira, Anabela; Parreira, Pedro; Vieira, Margarida; Graveto, JoãoContrary to many international settings, there are no clinical guidelines for peripheral intravenous catheter (PIVC) insertion and maintenance in Portugal. We sought to derive an international consensus on a PIVC bundle that could guide Portuguese nurses’ clinical decision-making in this scope. Methods: Two international vascular access specialist groups participated in an online Delphi panel. During the first round, specialists (n = 7) were sent a summary report from a previous observational study conducted in a surgical ward in Portugal. Based on the report findings, specialists were asked to provide five to eight PIVC insertion and maintenance interventions. Then, another set of specialists (n = 7) scored and revised the recommendations until a consensus was reached (≥70% agreement). The PIVC bundle was made available and discussed with the surgical ward’s nurses. Results: After three rounds, a consensus was achieved for five evidence-informed interventions: (i) involve the person and assess the peripheral venous network; (ii) maintain an aseptic no-touch technique; (iii) ensure proper catheter dressing and fixation; (iv) perform catheter flush & lock; (v) test the peripheral venous catheter’s functionality and performance at each shift. Conclusion: The final version of the PIVC bundle achieved consensus among international experts. Despite the positive feedback provided by the ward nurses, future studies are warranted to assess its effectiveness in standardizing PIVC care delivery and its potential implications for care outcomes in Portuguese clinical settings.
- Genetic variants in oxidative stress-related genes and their impact on prognosis and treatment response in chronic myeloid leukemia patientsPublication . Alves, Raquel; Ventura, Filipa; Jorge, Joana; Marques, Gilberto; Coucelo, Margarida; Diamond, Joana; Oliveiros, Bárbara; Pereira, Amélia; Freitas-Tavares, Paulo; Almeida, António M.; Gonçalves, Ana Cristina; Sarmento-Ribeiro, Ana BelaChronic myeloid leukemia (CML) is a clonal myeloproliferative neoplasia characterized by the BCR::ABL1 fusion gene, which codifies the BCR-ABL protein with increased tyrosine kinase activity. Despite the clinical results for the outstanding tyrosine kinase inhibitors (TKIs), drug resistance is a problem in CML management. Genetic variants that alter redox homeostasis by changing antioxidant enzyme expression or activity may influence patient responses and could enhance patient stratification. We aimed to assess the association of SOD2, CAT GPX1, NRF2, and KEAP1 genetic variants with TKI response and disease prognosis. For this purpose, we genotyped the variants rs4880 (SOD2), rs1050450 (GPX1), rs1001179 (CAT), rs6721961, rs4893819, rs35652124, rs6706649, rs13001694 (NFE2L2), and rs113540846 (KEAP1) via PCR in 187 CML patients. Our results show that variants in genes related to oxidative stress influence the development and degree of TKI resistance (allele G and GG genotypes of GPX1 and CT genotype of NFE2L2 rs4893819), the appearance of mutations in the BCR::ABL1 gene (AG genotype of NFE2L2 rs13001694 and genetic profile GGCTTCCCGG of the NFE2L2/KEAP1 axis), disease evolution (AG genotype of SOD2 and CT genotype of NFE2L2 rs4893819), and overall survival (CC genotype of CAT and GG genotype of NFE2L2 rs13001694) of CML patients. Our study found that variants in oxidative stress-related genes impact treatment response and outcomes in CML.
- Influence of genetic variants of oxidative stress related genes on prognosis and therapy response in chronic myeloid leukemiaPublication . Alves, Raquel; Ventura, Filipa; Jorge, Joana; Ribeiro, Ilda P.; Marques, Gilberto; Coucelo, Margarida; Diamond, Joana; Freitas-Tavares, Paulo; Almeida, António; Goncalves, Ana Cristina; Sarmento-Ribeiro, Ana BelaChronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by the presence of BCR-ABL1 oncogene. Oxidative stress conditions are crucial in tumor development and progression. The NRF2, codified by NFE2L2 gene, plays a central role in redox balance, promoting the transcription of cytoprotective and antioxidant genes such as SOD2, GPX1 and CAT. The action of this transcription factor is regulated by KEAP1. Alterations in these genes, either due to somatic mutations or genetic variants (SNV), have been associated with the development, prognosis, and therapeutic response in cancer. This work evaluated the influence of polymorphisms in genes associated with oxidative stress (NFE2L2, KEAP1, SOD2, GPX1, and CAT) in prognosis and treatment response with tyrosine kinase inhibitors (TKI) in CML patients. In 194 CML samples, nine genetic variants in NFE2L2 (rs6721961, rs4893819, rs35652124, rs6706649 and rs13001694), KEAP1 (rs113540846), SOD2 (rs4880), GPX1 (rs1050450) and CAT (rs1001179) were genotyped by PCR based assays. The association of these genetic variants with clinical-laboratory characteristics were assessed by Fisher’s test, logistic regression, and Kaplan-Meier curves, considering a p<0.05. The results obtained showed that patients with G allele on GPX1 rs1050450 and KEAP1 rs113540846 variants have an approximately 2-fold and 31-fold higher probability of being TKI resistant, respectively. In TKI-resistant group, patients with CT genotype in NFE2L2 rs4893819 variant were more likely to need three or more lines of treatment (OR=5.60, 95%CI 1.22-25.75, p=0.027). An important factor for TKI response is BCR-ABL1 mutational status, and we found that individuals with AG genotype in NFE2L2 rs13001694 present, approximately 9x more risk of mutation on this fusion gene. Moreover, patients heterozygous for the NFE2L2 rs4893819 (CT genotype) and SOD2 rs4880 (AG genotype) variants have faster disease progression [NFE2L2: hazard ratio (HR)=7.84, 95% CI 1.82-29.93, p=0.020; SOD2: HR=7.19, 95% CI 1.62-31.96, p=0.035] comparing with other genotypes. While the GG genotype of the NFE2L2 rs13001694 variant has a 2-fold lower overall survival than other patients (HR=11.86, 95% CI 1.39-1000.7, p=0.023). Additionally, we also observed an association between haplotypes and genotypic profile with CML prognosis. In conclusion, our results suggest that genetic variants in genes associated with the redox state might be important factors in the prognosis, survival, and therapy response in CML patients.
- Mapping complex interventions in Portuguese healthcare research: a scoping review protocolPublication . Ventura, Filipa; Araújo, Odete; Casaleiro, Tiago; Morgado, Tânia; Oliveira, CláudiaAlong with the worldwide recognition of the importance of the methodological guidance to the validity and rigour of complex health interventions, this scoping review aims to identify and characterise the scientific evidence on complex health interventions in Portuguese healthcare research. The Joanna Briggs Institute (JBI) guidance for scoping reviews will be followed. The population (P) concept (C) context (C) mnemonic will scaffold the research questions, inclusion and exclusion criteria, and searching strategy. MEDLINE, CINAHL, LILACS, and Open Access Scientific Repository of Portugal (RCAAP) will be searched. Scientific evidence reporting complex health interventions in the Portuguese healthcare context, in Portuguese and English and published from 2008 and onwards will be considered for inclusion. Literature pertaining to complex health interventions outside the Portuguese healthcare context will be excluded. The literature will be screened for eligibility by two independent reviewers first by title and abstract and subsequently by full-text. A data matrix will be used for data-extraction of the included literature. The charted data will be thematically analysed and presented graphically with a narrative description of the literature characteristics. The results from this literature review are expected to provide an overview of the knowledge concerning the characteristics and methodological guidance of Portuguese complex health interventions.
- Nurses' involvement in the development and usability assessment of an innovative peripheral intravenous catheterisation pack: a mix-method studyPublication . Santos-Costa, Paulo; Alves, Mariana; Sousa, Carolina; Sousa, Liliana B.; Paiva-Santos, Filipe; Bernardes, Rafael A.; Ventura, Filipa; Salgueiro-Oliveira, Anabela; Parreira, Pedro; Vieira, Margarida; Graveto, JoãoGuaranteeing peripheral venous access is one of the cornerstones of modern healthcare. Recent evidence shows that the lack of adequate clinical devices can result in the provision of substandard care to patients who require peripheral intravenous catheterization (PIVC). To address this challenge, we aimed to develop a PIVC pack for adult patients and assess the usability of this new device. Methods: Following a mix-method design, the PIVC pack development and usability assessment were performed in two phases with the involvement of its potential end-users (nurses). In phase one (concept and semi-functional prototype assessment), focus group rounds were conducted, and a usability assessment questionnaire was applied at each stage. In phase two (pre-clinical usability assessment), a two-arm crossover randomised controlled trial (PIVC pack versus traditional material) was conducted with nurses in a simulated setting. Final interviews were conducted to further explore the PIVC pack applicability in a real-life clinical setting. Results: High average usability scores were identified in each study phase. During the pre-clinical usability assessment, the PIVC pack significantly reduced procedural time (Z = −2.482, p = 0.013) and avoided omissions while preparing the required material (Z = −1.977, p = 0.048). The participating nurses emphasised the pack’s potential to standardise practices among professionals, improve adherence to infection control recommendations, and enhance stock management. Conclusions: The developed pack appears to be a promising device that can assist healthcare professionals in providing efficient and safe care to patients requiring a PIVC. Future studies in real clinical settings are warranted to test its cost-effectiveness.
- Nurses’ practices in the peripheral intravenous catheterization of adult oncology patients: a mix-method studyPublication . Santos-Costa, Paulo; Paiva-Santos, Filipe; Sousa, Liliana B.; Bernardes, Rafael A.; Ventura, Filipa; Fearnley, William David; Salgueiro-Oliveira, Anabela; Parreira, Pedro; Vieira, Margarida; Graveto, JoãoA significant number of adult oncology patients require at least one peripheral intravenous catheter to fulfill their therapeutic plan. Recent evidence indicates that catheter failure rates are high in this cohort, impacting care outcomes and patient experience during cancer treatment. This reality represents a challenge to nurses worldwide since in most international settings they are responsible for delivering quality care during the insertion and maintenance of such devices. This study aims to explore current nursing practices regarding the insertion, maintenance, and surveillance of peripheral intravenous catheters in oncology patients. A two-phase mix-method study was conducted with the nursing team from the surgical ward of a large oncology hospital in Portugal. In phase one (observational prospective study), nurses’ practices during catheter insertion and maintenance were observed by the research team and recorded using standardized instruments and validated scales. In phase two, three online focus groups were conducted with the nursing team to present the results observed in phase one and explore their perceptions of current practices. All ethical principles were assured throughout the study. Significant divergent practices were observed and identified by the nurses, especially concerning patient involvement, nurses’ adherence to the aseptic, non-touch technique, catheter stabilization and dressing, and catheter flushing and locking. Such practices may partially explain the high complication rate found (26%) and substantiate the need for future intervention in this field.
- Portuguese translation, cultural adaptation, and validation of the Person-Centred Practice Inventory – Staff (PCPI-S)Publication . Ventura, Filipa; Costa, Paulo; Chaplin, John; Domingues, Inês; Ferreira, Ricardo Jorge de Oliveira; McCormack, Brendan; Parreira, Pedro; Sousa, Liliana B.Aiming to translate, culturally adapt, and psychometrically evaluate the Person-centred Practice Inventory – Staff (PCPI-S) for Portuguese healthcare professionals, this methodological study was conducted sequentially in two phases. Phase I followed the 10-steps recommendations from the ISPOR taskforce for translation and cultural adaptation of patient reported outcome measures. Phase II comprised a quantitative cross-sectional virtual survey of the translated PCPI-S with healthcare professionals, who were reached through snowball sampling from both primary and specialized care settings. The psychometric properties of the PCPI-S were determined by assessing reliability and construct validity. A sample of 304 healthcare professionals participated in Phase II. Ceiling effects were found. The overall internal consistency was excellent (>0.9). The confirmatory factor analysis showed a good model fit after minor modifications, revealing construct validity, and supporting the theoretical framework. In conclusion, the three-factorial model of PCPI-S adjusted to the studied sample is a valid and reliable instrument to assess the perceptions of healthcare professionals on person-centred practice in various Portuguese clinical contexts. Considering the ceiling effects, the effect of social desirability should be explored.
- Rethinking palliative care in a public health context: addressing the needs of persons with non-communicable chronic diseasesPublication . Tziraki, Chariklia; Grimes, Corrina; Ventura, Filipa; O'Caoimh, Rónán; Santana, Silvina; Zavagli, Veronica; Varani, Silvia; Tramontano, Donatella; Apóstolo, João; Geurden, Bart; Luca, Vincenzo de; Tramontano, Giovanni; Romano, Maria Rosaria; Anastasaki, Marilena; Lionis, Christos; Rodríguez-Acuña, Rafael; Capelas, Manuel Luís; Afonso, Tânia dos Santos; Molloy, David William; Liotta, Giuseppe; Iaccarino, Guido; Triassi, Maria; Eklund, Patrik; Roller-Wirnsberger, Regina; Illario, MaddalenaNon-communicable chronic diseases (NCCDs) are the main cause of morbidity and mortality globally. Demographic aging has resulted in older populations with more complex healthcare needs. This necessitates a multilevel rethinking of healthcare policies, health education and community support systems with digitalization of technologies playing a central role. The European Innovation Partnership on Active and Healthy Aging (A3) working group focuses on well-being for older adults, with an emphasis on quality of life and healthy aging. A subgroup of A3, including multidisciplinary stakeholders in health care across Europe, focuses on the palliative care (PC) model as a paradigm to be modified to meet the needs of older persons with NCCDs. This development paper delineates the key parameters we identified as critical in creating a public health model of PC directed to the needs of persons with NCCDs. This paradigm shift should affect horizontal components of public health models. Furthermore, our model includes vertical components often neglected, such as nutrition, resilience, well-being and leisure activities. The main enablers identified are information and communication technologies, education and training programs, communities of compassion, twinning activities, promoting research and increasing awareness amongst policymakers. We also identified key 'bottlenecks': inequity of access, insufficient research, inadequate development of advance care planning and a lack of co-creation of relevant technologies and shared decision-making. Rethinking PC within a public health context must focus on developing policies, training and technologies to enhance person-centered quality life for those with NCCD, while ensuring that they and those important to them experience death with dignity.
- Rethinking palliative care in a public health context: addressing the needs of persons with non-communicable chronic diseases - CORRIGENDUMPublication . Tziraki, Chariklia; Grimes, Corrina; Ventura, Filipa; O'Caoimh, Ronan; Santana, Silvina; Zavagli, Veronica; Varani, Silvia; Tramontano, Donatella; Apóstolo, João; Geurden, Bart; Luca, Vincenzo de; Tramontano, Giovanni; Romano, Maria Rosaria; Anastasaki, Marilena; Lionis, Christos; Rodríguez-Acuña, Rafael; Capelas, Manuel Luís; Afonso, Tânia dos Santos; Molloy, D. William; Liotta, Giuseppe; Iaccarino, Guido; Triassi, Maria; Eklund, Patrik; Roller-Wirnsberger, Regina; Illario, Maddalena