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- Body composition analysis in metastatic non-small-cell lung cancer: depicting sarcopenia in Portuguese tertiary carePublication . Mendes, José Leão; Ferreira, Rita Quaresma; Mata, Inês; Barreira, João Vasco; Rodrigues, Ysel Chiara; Dias, David Silva; Capelas, Manuel; Mäkitie, Antti; Guerreiro, Inês; Pimenta, Nuno; Ravasco, PaulaBackground/Objectives: Sarcopenia is an emergent prognostic biomarker in clinical oncology. Albeit increasingly defined through skeletal muscle index (SMI) thresholding, literature cut-offs fail to discern heterogeneous baseline muscularity across populations. This study assesses the prognostic impact of using cohort-specific SMI thresholds in a Portuguese metastatic non-small-cell lung cancer (mNSCLC) cohort. Methods: Retrospective study including mNSCLC patients treated between January 2017 and December 2022. ImageJ v1.54g was used to assess cross-sectional CT imaging at the third lumbar vertebra (L3) and calculate L3SMI. Sarcopenia was defined both according to Prado et al. and L3SMI thresholds derived from receiver operating characteristic analysis. Overall survival (OS) was the primary endpoint. Secondary endpoints included first-line (1L) progression-free survival (PFS) and sarcopenia subgroup analysis regarding body mass index impact on OS. Results: The initial cohort included 197 patients. Mean age was 65 years (± 11.31). Most tumors were adenocarcinomas (n = 165) and presented with metastasis (n = 154). SMI was evaluable in 184 patients: cohort-specific thresholds (< 49.96 cm2/m2 for men; < 34.02 cm2/m2 for women) yielded 46.74% sarcopenic patients (n = 86) versus 66.30% (n = 122) per the literature definition. Cohort-specific thresholds predicted both OS (12.75 versus 21.13 months, hazard ratio [HR] 1.654, p = 0.002) and PFS (7.92 versus 9.56 months, HR 1.503, p = 0.01). Conversely, Prado et al. definition lacked prognostic value. Among sarcopenic patients, overweight (HR 0.417, p = 0.01) and obesity (HR 2.723, p = 0.039) had contrasting impacts on OS. Conclusions: Amid reclassification of nearly one-fifth of the cohort, cohort-specific thresholds improved sarcopenia prognostication in mNSCLC. Homogeneity regarding both cancer treatment setting and ethnicity could be key to defining sarcopenia based on SMI.
- Abordagem à pessoa com lesões de pele associadas à humidadePublication . Almeida, Armando; Sousa, Filomena; Grilo, Liliana; Alves, Paulo; Ramos, PauloA preservação da integridade cutânea está considerada, à luz dos conhecimentos atuais, como um forte indicador da qualidade dos cuidados de saúde prestados, nomeadamente ao nível da prevenção de lesões. As Lesões de Pele Associadas à Humidade (LPAH) são causadas pela prolongada exposição da pele a fluidos e seus constituintes, de várias fontes. Existe um conjunto de mecanismos que interagem entre si, de forma a manter a homeostasia cutânea, impedindo a sua lesão. Contudo, em situações agudas ou crónicas, este equilíbrio fica comprometido e é necessária a intervenção externa para a prevenção e tratamento das lesões cutâneas. A APTFeridas elaborou este documento, com o apoio da 3M, como guia de orientação para as melhores práticas de prevenção e tratamento de Lesões Associadas à Humidade da Pele. Neste documento, para além de uma revisão da literatura, também encontrará instrumentos que ajudam na prática clínica, constituindo uma mais valia para a melhoria dos cuidados prestados à pessoa em risco ou com lesão de pele associada à humidade.
- Lived experience of comfort on sexuality and fertility for survivors of hematopoietic stem cell transplants: phenomenological studyPublication . Bacalhau, Lúcia; Pontífice-Sousa, PatríciaPurpose: To grasp the scope of sexuality and fertility within the lived experiences of comfort and discomfort among allogeneic stem cell transplant survivors. Methods: We employed a qualitative approach through van Manen's phenomenology of practice. The phenomenon was revealed via phenomenological interviews, incorporating narratives and illustrative episodes that captured the lived experiences of 20 survivors. We gathered descriptions of these experiences from participants from July 2020 to May 2021. During our phenomenological reflection on these accounts, we adhered to stages like epoché, reduction, and vocative, as outlined by van Manen (1). Results: The exploration of comfort within the realms of sexuality and fertility yielded several themes: desire and the relationship; immunosuppression as a limitation on sexual activit; the body does not correspond to desire; the future: fertility and the couple's relationship; the challenges of disclosure and intervention. Conclusion: The findings indicate that survivors have long-term challenges with sexual expression and activity, stemming from the physical constraints of GVHD, perceptions of their immunosuppression, and the significance of their partnership, all of which translate into requirements for nursing care. Implications for Cancer Survivors Considering the experiences of these participants and the observed comfort linked to the sexuality of AHSCT survivors, we can contemplate the care practices and recognize sexuality as a field of action for nurses in this context to enhance comfort for these individuals.
- Online holistic program to foster health amongst students: a pilot study in a Portuguese university during COVID-19 pandemicPublication . Veiga, Elisa; Duarte, Raquel; Capela, Inês; Pinto, Elisabete; Silva, Margarida; Sá, Cristina; Sá, Luís; Kunz, Sahra; Serra, Sofia; Pereira, Henrique; Machado, Bárbara C.; Gomes, Ana; Pimenta, Ana; Almeida, Armando; Silva, Patrícia O.; Correia, MartaDuring the COVID-19 pandemic, several preventive mental health interventions took place to increase the psychological well-being of university students due to the high levels of stress, anxiety and negative emotions experienced in that period. This context reinforced the role of universities in supporting students and preventing the mental health risk factors they faced. In this context a multidisciplinary team of professionals (psychologists, nurses, nutritionists, and artists) in the Portuguese Catholic University, gathered efforts and developed an holistic intervention program for university students based on a mind and body integrated approach. This program of 8 online sessions aims to improve students’ resilience to the psychosocial consequences of COVID-19 pandemic and promote their wellbeing. The twenty university students that participated in this pilot study reported that this intervention improved their emotional self-awareness, their ability to apply self-care strategies, as well as they believed it promoted healthier lifestyle changes. These findings suggest that this program consists in an innovative approach with the potential to promote the psychological health and well-being of university students in adverse circumstances.
- Biocompatibility and effectiveness of a novel organic olive oil-based denture adhesive: a multicenter randomized and placebo-controlled clinical trialPublication . Azevedo, Luís; Correia, André; Almeida, Carlos F.; Molinero-Mourelle, Pedro; Correia, Maria; Hisghsmith, Jaime Del RíoTo assess the clinical efficacy of a novel organic olive oil-based denture adhesive and its effect on Candida Albicans growth in maxillary edentulous individuals wearing complete dentures. Individuals were selected from two Dental Schools in Portugal and Spain. Twenty-eight complete dentures were relined, following a standardized protocol. The novel product (Test) was compared with a commercialized adhesive (Control) and Vaseline (Placebo) randomly assigned in a crossstudy design. The retention resistance was measured with a Gnathometer and a dynamometer, the patient related outcome evaluations with a 5-points questionnaire and the Candida albicans growth in a Sabouraud dextrose agar (SDA) medium in order to evaluate differences between the placebo and experimental product. Twenty-three participants were included. Dynamometer evaluation showed significant differences between not using a denture adhesive and using either (experimental, p = .03; control, p = .04), no significant differences between the two adhesives (p > .05). In the subjective analysis, the experimental adhesive showed a significantly longer effectiveness (p = .001); the control reported better results at taste (p = .03) in chewing (p = .001). The test adhesive showed better (p < .001) Candida albicans growth inhibition. The experimental adhesive showed longer effectiveness than the control and placebo with a better inhibition capacity for the growth of Candida albicans, patients reported better abilities for speech, chewing, taste and retirement in the control adhesive.
- Literacia em cuidados paliativos dos professores da formação prégraduada dos cursos de enfermagem, medicina, psicologia e serviço social: protocolo de uma revisão scopingPublication . Soares, Marta Sofia Barroso; Capelas, Manuel Luís Vila; Lopes, ManuelIntrodução: Os cuidados paliativos são cuidados que deveriam ser disponibilizados a todas as pessoas com doenças crónicas e ameaçadores da vida. De acordo, com o Relatório da Lancet Commission on Palliative Care and Pain Relief Study Group apenas 14% da população mundial com necessidades de cuidados paliativos, tem acesso a estes. A referida Comissão em 2017 evidenciou a necessidade de mudança face a uma prevalência de 61 milhões de pessoas com sofrimento associado a doenças graves, e que contestam a urgência de se desenvolverem esforços para aliviar a desigualdade na prestação de cuidados paliativos. De forma a combater estas desigualdades e aumentar a formação em cuidados paliativos, uma das recomendações nacionais e internacionais é que a formação em cuidados paliativos seja integrada em todos os cursos de formação prégraduada na área da saúde e social, para que se formem profissionais nestas áreas com formação básica em cuidados paliativos. A questão que deu origem à futura revisão scoping foi: Qual a literacia em cuidados paliativos dos professores da formação pré-graduada dos cursos de enfermagem, medicina, psicologia e serviço social? Deste modo, surgiu a necessidade de mapear e sintetizar a evidência científica sobre o conceito de literacia em cuidados paliativos dos professores da formação pré-graduada dos cursos de enfermagem, medicina, psicologia e serviço social. Após uma breve pesquisa, não foi encontrado nenhum protocolo de revisão ou revisões sistemáticas atuais sobre a questão colocada. Objetivo: Mapear a evidência sobre literacia em cuidados paliativos dos professores da formação pré-graduada dos cursos de enfermagem, medicina, psicologia e serviço social. Materiais e Métodos: Para a elaboração da revisão, seguir-se-á as recomendações do Preferred Reporting Items for Systematic Reviews and MetaAnalyses - extension for Scoping Review (PRISMA-ScR). Os critérios de inclusão foram determinados utilizando o acrónimo “PCC” que se traduz em população, conceito e contexto. Assim a “População” serão os professores do ensino superior da formação pré-graduada dos cursos de enfermagem, medicina, psicologia e serviço social, o “Conceito” será a literacia em cuidados paliativos e por último o “Contexto” será a formação pré-graduada dos cursos de enfermagem, medicina, psicologia e serviço social. Serão excluídos todos os artigos que não cumpram os critérios acima referidos. A seleção dos estudos será realizada por dois revisores independentes, de forma cega e por meio da plataforma Rayyan disponibilizada pelo Qatar Computing Research Institute (QCRI). Conclusão: A elaboração do presente protocolo pretende facilitar a realização da revisão scoping aqui estruturada.
- Saliva for diabetes’ complications: non-invasive diagnostics and monitoringPublication . Esteves, Eduardo; Mendes, Vera; Manadas, Bruno; Lemos, António; Alves, Dora; Bernardino, Liliana; Correia, Maria; Barros, Marlene; Esteves, Ana C.; Rosa, NunoType 2 Diabetes Mellitus is a chronic metabolic disease that poses a significant long-term health risk due to its debilitating complications. While the diagnosis and monitoring of diabetes are well-established, the monitoring of its numerous complications presents a challenge, which can compromise patients' prognosis and quality of life. We analyzed the proteome of ten saliva samples, five from healthy individuals and five from patients with Type 2 Diabetes Mellitus. The aim was to identify potential biomarkers of Type 2 Diabetes Mellitus and its complications. We used PANTHER and FUNRICH tools to conduct a functional analysis and enrichment approach. Our findings revealed 622 proteins involved in 16 disrupted biological processes, which are linked to Type 2 Diabetes Mellitus. Metabolic processes, response to stimuli, processes of the immune system, and signaling are notable due to their known relation with Type 2 Diabetes Mellitus. Enrichment analysis has revealed that there are eleven biological processes that have been deregulated. These processes involve twenty different salivary proteins that are associated with multiple complications in diabetes. Our findings demonstrate that saliva is a dependable source of possible biomarkers that can be used to monitor diabetes and its complications.
- The use of interprofessional education programs in health care: a scoping review protocolPublication . Pina, Rui; Soares, Tânia; Rabiais, Isabel; Nunes, Elisabete; José, HelenaObjective: The objective of this scoping review will be to map and summarize the scientific evidence about interprofessional education programs (IPE) used in health care in order to inform future research. Introduction: The authors consider that implementation of an IPE program in their organizations will contribute to a better quality of health care. It must be sensitive to the evidence concerning the topic. This scoping review intends to map and summarize that evidence as it is very dispersed, making it difficult to approach. Inclusion criteria: Will be included studies and papers that address IPE programs used by health teams, with two or more professional groups, necessarily including nurses, in any health care setting. Scientific studies to health teams with students will be excluded, as well as papers in which the use of IPE program has not been evaluated. Methods: The proposed scoping review will be conducted in accordance with the JBI methodology for scoping reviews(1). Search strategy will aim to locate articles published in English, Portuguese and Spanish, both publish and unpublished primary studies, reviews and texts and opinion papers. Studies will be selected by two independent reviewers and any disagreement will be resolved through discussion or with a third reviewer. Data extraction will be performed by the same two independent reviewers using a data extraction tool developed by them. The data will be presented graphically or in diagrammatic or tabular form, accompanied by a narrative summary.
- Critical care nursing to acute respiratory distress syndrome patients undergoing extracorporeal membrane oxygenation: a scoping review protocolPublication . Faia, Isabel; Branco, Mário; Rabiais, Isabel C. M.Objective: The objective of this scoping review is to map and understand the extent of the available scientific evidence regarding critical care nursing to acute respiratory distress syndrome (ARDS) patients undergoing extracorporeal membrane oxygenation (ECMO). Introduction: At a first approach, the evidence about critical care nursing to ARDS patients undergoing ECMO, appears that falls short to identify and describe nursing care interventions. Inclusion criteria: This scoping review research strategy is based on the definition of the participants, concept and context (PCC), the main elements used to establish inclusion and exclusion criteria (Peters et al., 2020). Concerning the participants, this research will focus on critically ill patients with ARDS undergoing ECMO. The inclusion criteria pondered will reflect only on adult patients. The concept considered will be critical care nursing. Studies involving ECMO cardiac support (VA-ECMO) will be excluded. Finally, the central context will be adult intensive care units (ICU). Methods: This protocol articulates a pathway and is based on The Joanna Briggs Institute (JBI) methodology guidelines. All studies included regardless of language will consider a timeline limit of five years. The first approach is based on a digital research, in order to identify the relevant vocabulary. Afterwards a scientific data bases research will be conducted in Medical Literature Analysis and Retrieval System Online (MEDLINEâ), in Cumulated Index to Nursing and Allied Health Literature (CINAHLâ) and in PubMedâ (Public/Publisher search engine accessing primarily MEDLINE database and others, present at the United States National Library of Medicine), using the keyword expression, that will best serve the sensitivity for the search. The studies selection will be based on the prior established headings, considering the inclusion and exclusion criteria set previously. The list of references will ponder articles, reviews and international guidelines. The data extraction will involve two independent reviewers, and if necessary, a third one will be considered. The results will be presented in a descriptive approach, with statistical charts and graphics.
- Use of Glass-ionomer cement as a restorative material: a systematic reviewPublication . Panetta, Alessandro; Lopes, Pedro Campos; Novaes, Tatiane Fernandes; Rio, Rute; Mello-Moura, Anna Carolina VolpiBackground: The clinical applications of glass ionomers cements (GICs) are varied: restoration, lining material, sealing, hyper sensibility care and temporary cavity restoration. Due to the lack of physical properties, over time modifications of GICs were experimented and studied by the addition of metals, fibers, ceramics to the GIC powder in the attempt to overcome these problems and improve the material and clinical performance. The aim of this study was to evaluate whether primary and permanent teeth can be definitively restored with glass ionomer cements, based on the PICO(S) question “What is the clinical performance in primary and permanent teeth restored with glass ionomer cements?”, Methods: A systematic search of the studies available in the literature was conducted in the electronic databases MEDLINE/Pubmed, Scopus and Web of Science. Two independent, calibrated examiners. The eligibility criteria were: (1) to be a systematic review (2) to evaluate the clinical longevity of GICs in primary and permanent teeth (3) to be clinical trials. The systematic reviews that met these criteria were reviewed in their entirety and those who presented at least one of the following exclusion criteria were then considered ineligible: (1) not being a systematic review of clinical trials; (2) not evaluating the longevity/clinical performance of GICs; (3) studies of dental restorative materials in teeth with enamel alterations. Results: A systematic literature search in MEDLINE/PubMed, Scopus and Web of Science databases identified 132 references potentially relevant. Twenty-four eligible articles were identified, only 13 articles were included. Methodological quality was measured using the AMSTAR-2 tool and the risk of bias of the included systematic reviews by the ROBIS tool. The level of evidence analysis was performed using the GRADE tool. Conclusions: Glass ionomer cements seems to be a viable choice in both dentitions, but primary dentition presents more evidence, especially regarding the Atraumatic Restorative Treatment (ART) technique. There is conflicting evidence on which type of glass ionomer is the best and comparisons to other dental materials are lacking. In conclusion, more high-quality studies are needed with longer follow up periods (>6 years), especially in permanent teeth.