Browsing by Author "Almeida, R"
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- ARIA Digital Anamorphosis: Digital Transformation of Health and Care in Airway Diseases from Research to PracticePublication . Bousquet, J; Anto, JM; Bachert, C; Haahtela, T; Zuberbier, T; Czarlewski, W; Bedbrook, A; Bosnic-Anticevich, S; Walter Canonica, G; Cardona, V; Costa, E; Costa, DJ; Courbis, AL; Custovic, A; Cvetkosvki, B; D'Amato, G; da Silva, J; Dantas, C; Dokic, D; Dauvilliers, Y; De Feo, G; Cruz, AA; De Vries, G; Devillier, P; Di Capua, S; Dray, G; Dubakiene, R; Durham, SR; Dykewicz, M; Ebisawa, M; Gaga, M; El-Gamal, Y; Erhola, M; Heffler, E; Emuzyte, R; Farrell, J; Fauquert, JL; Fiocchi, A; Fink-Wagner, A; Fontaine, JF; Fuentes Perez, JM; Gemicioğlu, B; Gamkrelidze, A; Fokkens, WJ; Garcia-Aymerich, J; Gevaert, P; Gomez, RM; González Diaz, S; Gotua, M; Guldemond, NA; Guzmán, MA; Hajjam, J; Huerta Villalobos, YR; Humbert, M; Fonseca, JA; Iaccarino, G; Ierodiakonou, D; Iinuma, T; Jassem, E; Joos, G; Jung, K; Kaidashev, I; Kalayci, O; Kardas, P; Keil, T; Illario, M; Khaitov, M; Khaltaev, N; Kleine-Tebbe, J; Kouznetsov, R; Kull, I; La Grutta, S; Leonardini, L; Ljungberg, H; Lieberman, P; Lipworth, B; Ivancevich, JC; Lodrup Carlsen, K; Lopes-Pereira, C; Loureiro, C; Louis, R; Mair, A; Mahboub, B; Makris, M; Malva, J; Manning, P; Marshall, G; Jutel, M; Masjedi, M; Carreiro-Martins, P; Makela, M; Mathieu-Dupas, E; Maurer, M; De Manuel Keenoy, E; Melo-Gomes, E; Meltzer, E; Menditto, E; Mercier, J; Klimek, L; Micheli, Y; Miculinic, N; Mihaltan, F; Milenkovic, B; Mitsias, D; Moda, G; Mogica-Martinez, MD; Mohammad, Y; Montefort, S; Monti, R; Kuna, P; Morais-Almeida, M; Mösges, R; Münter, L; Muraro, A; Murray, R; Naclerio, R; Napoli, L; Namazova-Baranova, L; Neffen, H; Nekam, K; Kvedariene, V; Neou, A; Nordlund, B; Novellino, E; Nyembue, D; O'Hehir, R; Ohta, K; Okubo, K; Onorato, G; Orlando, V; Ouedraogo, S; Le, L; Palamarchuk, J; Pali-Schöll, I; Panzner, P; Park, H; Passalacqua, G; Pépin, JL; Paulino, E; Pawankar, R; Phillips, J; Picard, R; Larenas-Linnemann, DE; Pinnock, H; Plavec, D; Popov, T; Portejoie, F; Price, D; Prokopakis, E; Psarros, F; Pugin, B; Puggioni, F; Quinones-Delgado, P; Laune, D; Raciborski, F; Rajabian-Söderlund, R; Regateiro, F; Reitsma, S; Rivero-Yeverino, D; Roberts, G; Roche, N; Rodriguez-Zagal, E; Rolland, C; Roller-Wirnsberger, R; Lourenço, OM; Rosario, N; Romano, A; Rottem, M; Ryan, D; Salimäki, J; Sanchez-Borges, M; Sastre, J; Scadding, G; Scheire, S; Schmid-Grendelmeier, P; Melén, Erik; Schünemann, H; Sarquis Serpa, F; Shamji, M; Sisul, JC; Sofiev, M; Solé, D; Somekh, D; Sooronbaev, T; Sova, M; Spertini, F; Mullol, J; Spranger, O; Stellato, C; Stelmach, R; Thibaudon, M; To, T; Toumi, M; Usmani, O; Valero, A; Valenta, R; Valentin-Rostan, M; Niedoszytko, M; Pereira, M; van der Kleij, R; Van Eerd, M; Vandenplas, O; Vasankari, T; Vaz Carneiro, A; Vezzani, G; Viart, F; Viegi, G; Wallace, D; Odemyr, M; Wagenmann, M; Wang, Y; Waserman, S; Wickman, M; Williams, D; Wong, G; Wroczynski, P; Yiallouros, P; Yusuf, O; Zar, HJ; Okamoto, Y; Zeng, S; Zernotti, ME; Zhang, L; Shan Zhong, N; Papadopoulos, NG; Patella, V; Pfaar, O; Pham-Thi, N; Rolland, C; Samolinski, B; Sheikh, A; Sofiev, M; Suppli Ulrik, C; Todo-Bom, A; Tomazic, PV; Toppila-Salmi, S; Tsiligianni, I; Valiulis, A; Valovirta, E; Ventura, MT; Walker, S; Williams, S; Yorgancioglu, A; Agache, I; Akdis, CA; Almeida, R; Ansotegui, IJ; Annesi-Maesano, I; Arnavielhe, S; Basagaña, X; D Bateman, E; Bédard, A; Bedolla-Barajas, M; Becker, S; Bennoor, KS; Benveniste, S; Bergmann, KC; Bewick, M; Bialek, S; E Billo, N; Bindslev-Jensen, C; Bjermer, L; Blain, H; Bonini, M; Bonniaud, P; Bosse, I; Bouchard, J; Boulet, LP; Bourret, R; Boussery, K; Braido, F; Briedis, V; Briggs, A; Brightling, CE; Brozek, J; Brusselle, G; Brussino, L; Buhl, R; Buonaiuto, R; Calderon, MA; Camargos, P; Camuzat, T; Caraballo, L; Carriazo, AM; Carr, W; Cartier, C; Casale, T; Cecchi, L; Cepeda Sarabia, AM; H Chavannes, N; Chkhartishvili, E; Chu, DK; Cingi, C; Correia de Sousa, JDigital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.
- Aspectos Neuroquímicos da Doença de AlzheimerPublication . Almeida, R; Gonçalves, MA Doença de Alzheimer é uma das doenças neurodegenerativas progressivas mais graves, sendo frequente na população idosa. É responsável por um número significativo de casos de demência senil. Trata-se de um problema de saúde pública da maior importância, se tivermos em conta a tendência actual para o aumento significativo da longevidade da população mundial. Este artigo tem por objectivo rever as características neuroquímicas e histopatológicas da Doença de Alzheimer, bem como os mais recentes avanços terapêuticos nesta área.
- Asthma App Use and Interest Among Patients With Asthma: A Multicenter StudyPublication . Jácome, C; Almeida, R; Pereira, AM; Araújo, L; Correia, MA; Pereira, M; Couto, M; Lopes, C; Chaves Loureiro, C; Catarata, MJ; Santos, LM; Ramos, B; Mendes, A; Pedro, E; Cidrais Rodrigues, JC; Oliveira, G; Aguiar, AP; Arrobas, AM; Costa, J; Dias, J; Todo Bom, A; Azevedo, J; Ribeiro, C; Alves, M; Pinto, PL; Neuparth, N; Palhinha, A; Marques, JG; Martins, P; Trincão, D; Neves, A; Todo Bom, F; Santos, M A; Branco, J; Loyoza, C; Costa, A; Silva Neto, A; Silva, D; Vasconcelos, MJ; Teixeira, MF; Ferreira-Magalhães, M; Taborda Barata, L; Carvalhal, C; Santos, N; Sofia Pinto, C; Rodrigues Alves, R; Moreira, AS; Morais Silva, P; Fernandes, R; Ferreira, R; Alves, C; Câmara, R; Ferraz de Oliveira, J; Bordalo, D; Calix, MJ; Marques, A; Nunes, C; Menezes, F; Gomes, R; Almeida Fonseca, J
- Choroidal Thinning: Alzheimer's Disease and AgingPublication . Cunha, JP; Proença, R; Dias-Santos, A; Melancia, D; Almeida, R; Águas, H; Oliveira Santos, B; Alves, M; Ferreira, J; Papoila, AL; Louro, C; Castanheira-Dinis, AINTRODUCTION: The purpose of this study was to measure and to compare macular choroidal thickness (CT) between patients with mild Alzheimer's disease (AD), patients without AD, and elderly patients. METHODS: CT was measured manually in 13 locations at 500-μm intervals of a horizontal and a vertical section from the fovea. Linear regression models were used to analyze the data. RESULTS: Fifty patients with a diagnosis of mild AD (73.1 years), 152 patients without AD (71.03 years), and 50 elderly without AD (82.14 years) were included. In the AD patients, CT was significantly thinner in all 13 locations (P < .001-comparing with age-match group), and comparing with the elderly group, a more pronounced difference was found in two locations temporal to the fovea. DISCUSSION: Patients with AD showed a significant choroidal thinning even when compared with elderly subjects. The reduction of CT may aid in the diagnoses of AD, probably reflecting the importance of vascular factors in their pathogenesis.
- Determinants of the Use of Health and Fitness Mobile Apps by Patients With Asthma: Secondary Analysis of Observational StudiesPublication . Neves, AL; Jácome, C; Taveira-Gomes, T; Pereira, AM; Prates, S; Almeida, R; Amaral, RBackground: Health and fitness apps have potential benefits to improve self-management and disease control among patients with asthma. However, inconsistent use rates have been reported across studies, regions, and health systems. A better understanding of the characteristics of users and nonusers is critical to design solutions that are effectively integrated in patients' daily lives, and to ensure that these equitably reach out to different groups of patients, thus improving rather than entrenching health inequities. Objective: This study aimed to evaluate the use of general health and fitness apps by patients with asthma and to identify determinants of usage. Methods: A secondary analysis of the INSPIRERS observational studies was conducted using data from face-to-face visits. Patients with a diagnosis of asthma were included between November 2017 and August 2020. Individual-level data were collected, including age, gender, marital status, educational level, health status, presence of anxiety and depression, postcode, socioeconomic level, digital literacy, use of health services, and use of health and fitness apps. Multivariate logistic regression was used to model the probability of being a health and fitness app user. Statistical analysis was performed in R. Results: A total of 526 patients attended a face-to-face visit in the 49 recruiting centers and 514 had complete data. Most participants were ≤40 years old (66.4%), had at least 10 years of education (57.4%), and were in the 3 higher quintiles of the socioeconomic deprivation index (70.1%). The majority reported an overall good health status (visual analogue scale [VAS] score>70 in 93.1%) and the prevalence of anxiety and depression was 34.3% and 11.9%, respectively. The proportion of participants who reported using health and fitness mobile apps was 41.1% (n=211). Multivariate models revealed that single individuals and those with more than 10 years of education are more likely to use health and fitness mobile apps (adjusted odds ratio [aOR] 2.22, 95%CI 1.05-4.75 and aOR 1.95, 95%CI 1.12-3.45, respectively). Higher digital literacy scores were also associated with higher odds of being a user of health and fitness apps, with participants in the second, third, and fourth quartiles reporting aORs of 6.74 (95%CI 2.90-17.40), 10.30 (95%CI 4.28-27.56), and 11.52 (95%CI 4.78-30.87), respectively. Participants with depression symptoms had lower odds of using health and fitness apps (aOR 0.32, 95%CI 0.12-0.83). Conclusions: A better understanding of the barriers and enhancers of app use among patients with lower education, lower digital literacy, or depressive symptoms is key to design tailored interventions to ensure a sustained and equitable use of these technologies. Future studies should also assess users' general health-seeking behavior and their interest and concerns specifically about digital tools. These factors may impact both initial engagement and sustained use.
- Doenças do Movimento Induzidas pela Terapêutica com NeurolépticosPublication . Almeida, R; Borja Santos, MOs neurolépticos são fármacos que, quer o Psiquiatra quer o Neurologista, utilizam na sua prática clínica diária. Actuam, a nível do Sistema Nervoso Central, bloqueando os receptores dopaminérgicos pós-sinápticos D2, sendo a sua potência antipsicótica directamente proporcional a esse bloqueio. De entre os efeitos neurológicos secundários induzidos pela terapêutica com neurolépticos, as doenças do movimento são, simultaneamente, as mais importantes e frequentes. Será sobre elas que este trabalho incidirá, procurando os autores abordar os aspectos que consideram essenciais.
- Estado de Mal EpilépticoPublication . Gonçalves, M; Almeida, R; Pinto Viana, JO Estado de Mal Epiléptico é uma situação com expressão clínica variável, relacionando-se o seu prognóstico com a etiologia subjacente. O Estado de Mal Convulsivo constitui uma emergência médica associada com elevadas taxas de morbilidade e de mortalidade, sendo essencial uma intervenção terapêutica precoce e adequada. Os autores apresentam um esquema de protocolo terapêutico a utilizar neste quadro.
- Feasibility and Acceptability of an Asthma App to Monitor Medication Adherence: Mixed Methods StudyPublication . Jácome, C; Almeida, R; Pereira, AM; Amaral, R; Mendes, S; Alves-Correia, M; Vidal, C; López Freire, S; Méndez Brea, P; Araújo, L; Couto, M; Antolín-Amérigo, D; de la Hoz Caballer, B; Barra Castro, A; Gonzalez-De-Olano, D; Todo Bom, A; Azevedo, J; Leiria Pinto, P; Pinto, N; Castro Neves, A; Palhinha, Ana; Todo Bom, F; Costa, A; Chaves Loureiro, C; Maia Santos, L; Arrobas, A; Valério, M; Cardoso, J; Emiliano, M; Gerardo, R; Cidrais Rodrigues, JC; Oliveira, G; Carvalho, J; Mendes, A; Lozoya, C; Santos, N; Menezes, F; Gomes, R; Câmara, R; Rodrigues Alves, R; Moreira, AS; Bordalo, D; Alves, C; Ferreira, JA; Lopes, C; Silva, D; Vasconcelos, MJ; Teixeira, MF; Ferreira-Magalhães, M; Taborda-Barata, L; Cálix, MJ; Alves, A; Almeida Fonseca, JBackground: Poor medication adherence is a major challenge in asthma, and objective assessment of inhaler adherence is needed. The InspirerMundi app aims to monitor adherence while providing a positive experience through gamification and social support. Objective: This study aimed to evaluate the feasibility and acceptability of the InspirerMundi app to monitor medication adherence in adolescents and adults with persistent asthma (treated with daily inhaled medication). Methods: A 1-month mixed method multicenter observational study was conducted in 26 secondary care centers from Portugal and Spain. During an initial face-to-face visit, physicians reported patients' asthma therapeutic plan in a structured questionnaire. During the visits, patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients registered the intake (inhaler, blister, or other drug formulation) by using the image-based medication detection tool. At 1 month, patients were interviewed by phone, and app satisfaction was assessed on a 1 (low) to 5 (high) scale. Patients were also asked to point out the most and least preferred app features and make suggestions for future app improvements. Results: A total of 107 patients (median 27 [P25-P75 14-40] years) were invited, 92.5% (99/107) installed the app, and 73.8% (79/107) completed the 1-month interview. Patients interacted with the app a median of 9 (P25-P75 1-24) days. At least one medication was registered in the app by 78% (77/99) of patients. A total of 53% (52/99) of participants registered all prescribed inhalers, and 34% (34/99) registered the complete asthma therapeutic plan. Median medication adherence was 75% (P25-P75 25%-90%) for inhalers and 82% (P25-P75 50%-94%) for other drug formulations. Patients were globally satisfied with the app, with 75% (59/79) scoring ≥4,; adherence monitoring, symptom monitoring, and gamification features being the most highly scored components; and the medication detection tool among the lowest scored. A total of 53% (42/79) of the patients stated that the app had motivated them to improve adherence to inhaled medication and 77% (61/79) would recommend the app to other patients. Patient feedback was reflected in 4 major themes: medication-related features (67/79, 85%), gamification and social network (33/79, 42%), symptom monitoring and physician communication (21/79, 27%), and other aspects (16/79, 20%). Conclusions: The InspirerMundi app was feasible and acceptable to monitor medication adherence in patients with asthma. Based on patient feedback and to increase the registering of medications, the therapeutic plan registration and medication detection tool were redesigned. Our results highlight the importance of patient participation to produce a patient-centered and engaging mHealth asthma app.
- Fístulas Carótido-Cavernosas. Perspectivas de Diagnóstico e TerapêuticaPublication . Gonçalves, M; Reis, J; Almeida, REven though in clinical practice carotid cavernous fistulas (CCF) are not a frequent pathology, it should be a diagnostic hypothesis in face of a suggestive clinical presentation. We intended to review the diagnosis and the therapeutics, comparing them with the actual perspectives. Files of 25 patients with the diagnostic hypothesis of CCF, confirmed by conventional angiography in the HSAC Neuroradiology Department, were reviewed. In this group of patients, (5 males and 20 females), the fistulous aetiology was spontaneous in 10 and traumatic in 15. Clinically the symptom most often presented was diplopia (23 cases) and the most frequent encountered sign was ophthalmoplegia (20 cases). Of the Neuroradiologic investigation, CT scan (done to all patients) have shown an prominent superior ophthalmic vein as the most frequent abnormality. Angiographic study was based on Lasjaunias et al protocol (Surgical Neuroangiography, Vol. 2, Springer-Verlag). Surgery was the therapeutic approach for the traumatic fistulas; only 2 of the spontaneous were treated by endovascular route. Three patients are still under observation. In all the others cases there was a fistula exclusion.
- Luxação Palmar Isolada da Quinta Articulação Carpo-MetacárpicaPublication . Barros, A; Pinto, F; Varela, E; Almeida, R; Côrte-Real, NA luxação palmar isolada da quinta articulação carpo-metacárpica é rara. Esta lesão pode passar despercebida, sendo importante a suspeita clínica, levando a uma avaliação radiológica no perfil e incidências obliquas. O tratamento é controverso, estando descritas a redução fechada com fixação percutânea com fios de Kirshner percutâneos e a redução aberta com fixação interna. Apresentamos um caso clínico de luxação palmar do tipo cubital isolada e o seu tratamento. O resultado funcional aos 6 meses, de acordo com o score DASH, foi de 0.8. Apresentava-se sem queixas, desempenhado as suas atividades diárias sem restrições.
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