Browsing by Issue Date, starting with "2025-02-15"
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- The economic cost of nursing care of palliative patient in the emergency departmentPublication . Afonso, Tânia dos Santos; Capelas, Manuel Luís; Martins, Lurdes(1) Background: The economic cost of nursing care to palliative patients in avoidable hospital admission is unknown. (2) Methods: An observational, retrospective, and analytical study was used encompassing the economic cost of nursing care in a general hospital emergency department that uses descriptive and inferential statistical analysis. (3) Results: We have a sample of 273 palliative patients in preventable hospital admissions (76.3%, CI 95%: 71.7–80.8), deceased, in 2019. With a median of 84 years, about 80% were admitted home after 5 h of complaints, mainly due to respiratory symptoms. Patients remained for approximately 24 h in the emergency department, totaling a median of EUR 180.98 in nursing care costs per admission. (4) Conclusions: It was evident that with the knowledge obtained about palliative economic nursing costs, we could increase results, manage resources, and consolidate PC integration in health systems, as this study proved. This study was not registered.
- Pre-existing IgG antibodies to HCoVs NL63 and OC43 spike increased during the pandemic and after COVID-19 vaccinationPublication . Hasan, Zahra; Masood, Kiran Iqbal; Veldhoen, Marc; Qaiser, Shama; Alenquer, Marta; Akhtar, Mishgan; Balouch, Sadaf; Iqbal, Junaid; Wassan, Yaqub; Hussain, Shahneel; Feroz, Khalid; Muhammad, Sajid; Habib, Atif; Kanji, Akbar; Khan, Erum; Mian, Afsar Ali; Hussain, Rabia; Amorim, Maria Joao; Bhutta, Zulfiqar A.Preexisting immunity may be associated with increased protection against non-related pathogens such as, SARS-CoV-2. There is little information regarding endemic human coronaviruses (HCOVs) from Pakistan, which experienced a relatively low COVID-19 morbidity and mortality. We investigated antibodies to SARS-CoV-2 and HCoVs NL63 and OC43, comparing sera from prepandemic controls (PPC) period with responses in healthy controls from the pandemic (HC 2021). Further, we investigated the effect of inactivated and mRNA COVID-19 vaccinations on antibody responses to the pandemic and endemic coronaviruses. We measured IgG antibodies to Spike of SARS-CoV-2, HCoV-NL63 and HCoV-OC43 by ELISA. Serum neutralizing capacity was determined using a SARS-CoV-2 psuedotyped virus assay. Vaccinees were sampled prior to vaccination as well after 6, 12 and 24 weeks after COVID-19 inactivated (Sinovac), or mRNA (BNT162b2) vaccine administration. PPC sera showed seropositivity of 15 % to SARS-CoV-2, whilst it was 45 % in the HC 2021 group. Five percent of sera showed virus neutralizing activity in PPC whilst it was 50 % in HC 2021. IgG antibodies to Spike of NL63 and OC43 were also present in PPC; anti-NL63 was 2.9-fold, and anti-OC43 was 10.1-fold higher than to anti-SARS-CoV-2 levels. IgG antibodies to Spike SARS-CoV-2 were positively correlated with HCoV-NL63 in HC 2021, indicating recognition of shared conserved epitopes. IgG antibody levels increased during the pandemic; 2.7-fold to HCoV-NL63 and 1.9-fold to HCoV-OC43. SinoVac and BNT162b2 vaccine induced an increase in IgG antibodies to Spike SARS-CoV-2 as well as HCoV-NL63 and HCoV-OC43. Our data show that antibodies to spike protein of endemic coronaviruses were present in the prepandemic population. Antibodies to SARS-CoV-2, NL63 and OC43 were all raised during the pandemic and further enhanced after COVID-19 vaccinations. The increase in antibodies to spike of coronaviruses would contribute to protection against SARS-CoV-2.
- White matter alterations in episodic migraine without aura patients assessed with diffusion MRI: effect of free water correctionPublication . Guadilla, Irene; Fouto, Ana R.; Ruiz-Tagle, Amparo; Esteves, Inês; Caetano, Gina; Silva, Nuno A.; Vilela, Pedro; Gil-Gouveia, Raquel; Aja-Fernández, Santiago; Figueiredo, Patrícia; Nunes, Rita G.Objective To assess the efect of modeling free water (FW) on the identifcation of white matter (WM) microstructure alterations using difusion Magnetic Resonance Imaging (dMRI) in episodic migraine without aura patients compared with healthy controls. Background Difusion tensor imaging (DTI) studies examining WM in migraine patients previously overlooked the potential infuence of FW partial volume efects. Correcting FW efects could ofer a clearer understanding of WM changes in migraine. This study is the frst to incorporate FW efects when evaluating alterations in WM tracts in migraine patients, ofering a comparison to standard DTI analysis. Methods A group of 14 patients with low-frequency episodic menstrual-related migraine without aura and 15 healthy controls matched for the phase of the menstrual cycle were recruited and underwent dMRI acquisitions. FW partial volume fraction was estimated, the difusion signal corrected and the difusion parameters calculated from both FW-corrected and uncorrected signals. Tract-Based Spatial Statistics (TBSS) and WM skeleton regions of interest (ROI) analyses were used to compare between groups. Results Comparisons between control subjects and migraine patients with TBSS and ROI analyses revealed signifcantly lower axial difusivity (AD), both with and without FW correction, as well as altered FW values in migraine patients in some WM tracts. TBSS detected MD changes only after FW correction. Conclusions These fndings suggest WM alterations in these migraine patients in comparison with control subjects, in accordance with other migraine studies. Diferences in the difusion parameters might point to infammatory processes in migraine related to cellular swelling.