Browsing by Issue Date, starting with "2020-05"
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- Risco de burnout nos técnicos de radiologia das unidades de saúde do PortoPublication . Silva, Cristiana; Pereira, José ManuelIntrodução – O burnout é descrito como uma síndroma que envolve exaustão emocional, física e mental e que resulta da exposição continuada ao stress laboral. É caracterizada por elevada exaustão emocional, despersonalização e baixa realização pessoal. Objetivo – Este estudo procurou avaliar o risco de burnout nos técnicos de radiologia que exercem funções em instituições de saúde da região do Porto, Portugal. Materiais e Métodos – Os níveis de burnout foram estimados através do Maslach Burnout Inventory – Human Services Survey composto por 22 questões. A amostra foi constituída por 122 indivíduos, provenientes de sete instituições de saúde, públicas e privadas, em que 61,5% eram do sexo feminino, com média de idades e desvio-padrão de 38,3 (±9,3) anos. Na análise relacional entre as variáveis sociodemográficas e os resultados do MBI-HSS foram utilizados os testes Qui-quadrado de Pearson ou Exato de Fisher, conforme a percentagem de células com contagem menor que 5 era menor ou maior que 20% para as variáveis qualitativas. Para as variáveis quantitativas realizaram-se os testes ANOVA ou Kruskal-Wallis, conforme a homogeneidade da variância entre grupos. A interpretação dos testes estatísticos correlacionais foi efetuada com base no nível de significância de α=0,05 com intervalo de confiança de 95%. Resultados – A análise dos níveis das dimensões do burnout revelou valores médios de 21,73 (±11,37) para a exaustão emocional, de 7,42 (±5,40) para a despersonalização e de 32,79 (±8,46) para a realização pessoal, o que se coaduna com níveis moderados para as duas primeiras dimensões e baixos para a última. Deste grupo de técnicos, 39,3% e 29,5% exibem elevados níveis de exaustão emocional e despersonalização, respetivamente. A baixa realização pessoal é experienciada por 48,4% dos inquiridos. Discussão – As mulheres são mais afetadas pela exaustão emocional (51%), bem como os profissionais com tempo na função entre os 11 e os 30 anos. Em serviços compostos por 20 a 40 técnicos observa-se um nível mais elevado de exaustão emocional (63%). A maioria dos inquiridos afirma que o trabalho afeta a sua autoestima, vida familiar e social, nomeadamente de forma negativa, o que posteriormente se relaciona com alguns valores elevados de exaustão emocional e despersonalização e baixos de realização pessoal. Conclusão – A ocorrência de burnout nos técnicos de radiologia é relevante e estes resultados alertam para a necessidade de intervir no sentido de melhorar as condições de trabalho, formação contínua e implementação de medidas de suporte emocional dos profissionais de saúde, de forma a garantir a qualidade do serviço prestado aos utentes e o bem-estar pessoal destes profissionais.
- Conjunctivitis in patients with atopic dermatitis treated with dupilumabPublication . Ferreira, Sandra; Torres, TiagoAtopic dermatitis (AD) is a common, chronic, inflammatory skin disorder with high physical and emotional burden. Robust evidence suggests that interleukin (IL)-4 and IL-13 are key cytokines in the immunopathogenesis of AD. New emerging agents include dupilumab, a fully human monoclonal antibody directed against the IL-4 receptor a subunit that blocks both IL-4 and IL-13 signaling and has shown significant efficacy in patients with moderate-to-severe AD. Dupilumab is approved for the treatment of moderate-to-severe AD, moderate-to-severe eosinophilic or oral corticosteroid-dependent asthma, and chronic rhinosinusitis with nasal polyps. Data from phase phase 2 and 3 studies have revealed that dupilumab generally has a low rate of adverse events, although an increased incidence of mild-to-moderate conjunctivitis has been reported for dupilumab compared with placebo. The present paper reviews the data of dupilumab-associated conjunctivitis and risk factors in adults with moderate-to-severe AD and other atopic diseases in dupilumab clinical trials and addresses the characteristics and treatment options available for this clinically highly relevant condition. Additionally, it presents data from ten studies in the real-life setting with dupilumab. Dupilumab-associated conjunctivitis incidence is higher in AD, although most cases are mild-to-moderate and have good response to topical treatment, with no need to suspend dupilumab therapy
- Severe Pulmonary Hypertension Management Across Europe (PHAROS): an ERS Clinical Research CollaborationPublication . Sitbon, Olivier; Reis, Abilio; Humbert, Marc; Vonk Noordegraaf, Anton; Delcroix, MarionThe overall objective of the PHAROS CRC is to establish a platform for clinical research in pulmonary hypertension, in close collaboration with the ERN-Lung, able to coordinate future collaborative research in Europe https://bit.ly/2Rx2FTl
- Psoriasis, biologic therapy, and the pandemic of the 21st centuryPublication . Nogueira, Miguel; Vender, Ron; Torres, TiagoThe pandemic known as coronavirus disease-19 (COVID-19) has quickly spread worldwide, with a significant impact on lives all over the world. The complexity related to the new coronavirus and the clinical syndrome it causes is not yet fully understood. The impact of COVID-19 on patients with psoriasis under biologic agents is continuously being observed in this rapidly changing pandemic. A case-by-case evaluation must be made by dermatologists, and the final decision should be discussed and decided by both the patient and the specialist. Observations reveal that immunosuppressive therapy may have a role in the treatment of this virus, placing emphasis on the scenario of safety through maintenance of therapy with biologic agents, especially when there are no signs or symptoms related to the infection or contact with an infected patient.
- Intradermal Tests With Drugs: An Approach to StandardizationPublication . Barbaud, Annick; Weinborn, Marie; Garvey, Lene Heise; Testi, Sergio; Kvedariene, Violeta; Bavbek, Sevim; Mosbech, Holger; gomes, eva; Aberer, Werner; Elberink, Hanneke N. G. Oude; Torres, Maria Jose; Ponvert, Claude; Ayav, C.; Gooi, Jimmy; Brockow, KnutBackground: Intradermal tests (IDTs) are performed and interpreted differently in drug allergy centers making valid comparison of results difficult. Objective: To reduce method-related and intercenter variability of IDTs by the introduction of a standardized method. Materials and methods: In 11 centers of the European Network for Drug Allergy, IDTs were prospectively performed with saline and with amoxicillin (20 mg/ml) using (1) the local method and (2) the standardized European Network in Drug Allergy (ENDA) method (0.02 ml). The diameters of the initial injection wheal (Wi) for the different volumes and sites injected obtained from each center were analyzed. Results: The most reproducible method was to fill a syringe with test solution, then expel the excess fluid to obtain exactly 0.02 ml. The median Wi diameter with 0.02 ml injection using the standardized method was 5 mm [range 2-10 mm; interquartile range (IQR) 5-5 mm; n = 1,096] for saline and 5 mm (range 2-9 mm; IQR = 4.5-5 mm; n = 240) for amoxicillin. IDT injection sites did not affect the Wi diameter. Training improved precision and reduced the variability of Wi diameters. Conclusion: Using the standardized IDT method described in this multicenter study helped to reduce variability, enabling more reliable comparison of results between individuals and centers.
- The epidemiology of multiple sclerosis in the entre Douro e Vouga region of northern Portugal: a multisource population-based studyPublication . Branco, Mariana; Alves, Ivânia; Martins da Silva, Ana; Pinheiro, Joaquim; Sá, Maria José; Correia, Inês; Sousa, Lívia; Brandão, Eva; Veira, Carlos; Gomes, Bernardo; Ruano, LuisBackground: The prevalence of Multiple Sclerosis (MS) has been increasing worldwide and the north-south gradient of prevalence may be disappearing in the Northern hemisphere. The few previous prevalence studies performed in Portugal have reported a lower prevalence than the average for Western Europe. The aim of this study is to estimate the prevalence of MS in the Entre Douro e Vouga region, in Northern Portugal. Methods: Multiple overlapping sources were used to ascertain all cases from the reference population: records from hospitals in the region and neighbouring regions; diagnostic databases of primary care physicians; and applications for disability benefits. The prevalence date was set at 1 January 2014. The reference population was 274,859 inhabitants. Patients' neurologists were contacted to retrieve clinical information and confirm the diagnosis based. Results: A total of 177 patients were identified after eliminating duplicates from different sources. The female to male ratio was 1.9 and the mean age at disease onset was 33.5 (standard deviation: 10.3). Clinically isolated syndrome accounted for 9.0% of patients, relapsing remitting for 58.8%, secondary progressive for 20.3% and primary progressive for 11.8%. The prevalence was estimated in 64.4 patients per 100,000 (95% confidence interval: 54.9;73.9). Conclusions: In this study we report a higher point prevalence of MS than had been previously described in Portugal, but still far from the higher values recently reported in other Southern European countries.
- Urinary Biomarkers in Bladder Cancer: Where Do We Stand and Potential Role of Extracellular VesiclesPublication . Castanheira De Oliveira, Manuel; Caires, Hugo R.; Oliveira, Maria J; Fraga, Avelino; Vasconcelos, M. Helena; Ribeiro, RicardoExtracellular vesicles (EVs) are small membrane vesicles released by all cells and involved in intercellular communication. Importantly, EVs cargo includes nucleic acids, lipids, and proteins constantly transferred between different cell types, contributing to autocrine and paracrine signaling. In recent years, they have been shown to play vital roles, not only in normal biological functions, but also in pathological conditions, such as cancer. In the multistep process of cancer progression, EVs act at different levels, from stimulation of neoplastic transformation, proliferation, promotion of angiogenesis, migration, invasion, and formation of metastatic niches in distant organs, to immune escape and therapy resistance. Moreover, as products of their parental cells, reflecting their genetic signatures and phenotypes, EVs hold great promise as diagnostic and prognostic biomarkers. Importantly, their potential to overcome the current limitations or the present diagnostic procedures has created interest in bladder cancer (BCa). Indeed, cystoscopy is an invasive and costly technique, whereas cytology has poor sensitivity for early staged and low-grade disease. Several urine-based biomarkers for BCa were found to overcome these limitations. Here, we review their potential advantages and downfalls. In addition, recent literature on the potential of EVs to improve BCa management was reviewed and discussed.