Browsing by Author "Cunha, L"
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- Comportamentos dos Enfermeiros Perante os Alarmes Clínicos em Unidades de Cuidados Intensivos: uma Revisão IntegrativaPublication . Galo, AR; Diogo, C; Cipriano, D; Araújo, I; Martins, J; Cunha, LO presente estudo tem como propósito refletir sobre a prática de enfermagem no que concerne à temática da monitorização hemodinâmica. Pretendemos identificar a evidência empírica produzida sobre o comportamento dos enfermeiros perante os alarmes clínicos e, consequentemente, incentivar a adoção de estratégias que promovam um ambiente de cuidados intensivos menos ruidoso. Perspetivou-se um estudo de revisão sistemática da literatura. Selecionámos um conjunto de dezoito bases de dados eletrónicas, tendo recorrido a três idiomas. A colheita de informação decorreu entre dezembro de 2011 e janeiro de 2012 e, através de uma estratégia de cruzamento dos descritores selecionados, foram incluídos 5 artigos. Face a todo o corpo de discussão salientamos três categorias essenciais: opinião dos profissionais de saúde acerca dos alarmes clínicos; comportamento dos profissionais; estratégias promotoras de um ambiente menos ruidoso. Constatamos que os profissionais de saúde têm presente a bipolaridade dos alarmes clínicos e identificam limitações na sua gestão. Verificamos ainda que o comportamento dos profissionais nos estudos analisados não é linear, variando entre alterar os parâmetros no início de cada turno até ignorar uma grande maioria deles. Cientes desta realidade, os profissionais sugerem diversas estratégias passíveis de implementar, com vista a alarmes e comportamentos mais eficazes.
- Molecular Profile of Sensitization to Dermatophagoides Pteronyssinus Dust Mite in PortugalPublication . Limão, R; Spínola Santos, A; Araújo, L; Cosme, J; Inácio, F; Tomaz, E; Ferrão, A; Santos, N; Sokolova, A; Môrete, A; Falcão, H; Cunha, L; Ferreira, A; Bras, A; Ribeiro, F; Lozoya, C; Leiria-Pinto, P; Prates, S; Plácido, J; Coimbra, A; Taborda-Barata, L; Pereira Santos, MC; Pereira Barbosa, M; Pineda, FBackground and objectives: To analyze component-resolved diagnosis of sensitization to Dermatophagoides pteronyssinus (Der p) in patients with respiratory allergy and the association between diagnostic findings and clinical severity in different geographical areas. Methods: The study population comprised 217 patients (mean age, 25.85 [12.7] years; 51.16% female) selected from 13 centers in Portugal (5 from the North, n=65). All had allergic rhinitis with or without asthma and positive skin prick test results to at least 1 dust mite. Specific IgE (sIgE) to Der p, Dermatophagoides farinae, Lepidoglyphus destructor, Der p 1, Der p 2, Der p 10, and Der p 23 was determined using ImmunoCAP. The Mann-Whitney test was applied for the following comparisons: rhinitis vs rhinitis and asthma; mild vs moderate-to-severe rhinitis; North vs South. Results: The prevalence of sensitization was 98.2% for Der p, and 72.4%, 89.4%, 9.7%, and 77% for Der p 1, Der p 2, Der p 10, and Der p 23, respectively. The corresponding median sIgE levels were 8.56, 17.7, 0.01, and 3.95 kUA/L. sIgE to all allergens was higher in patients with moderate-to-severe rhinitis and rhinitis with asthma (nonsignficant). Concentrations of sIgE to Der p 2 were significantly higher in the South than in the North (P=.0496). Conclusion: The most common sensitization in Portugal was to Der p. The highest prevalence and median sIgE level were observed for Der p 2. All sIgE values for molecular components were higher in more symptomatic patients (nonsignificant). Concentrations of sIgE to Der p 2 were higher in the South, probably because of the warmer temperature and/or the larger sample size.
- Nocturnal Blood Pressure Dipping in Acute Ischemic StrokePublication . Sargento-Freitas, J; Laranjinha, I; Galego, O; Rebelo-Ferreira, A; Moura, B; Correia, M; Silva, F; Machado, C; Cordeiro, G; Cunha, LOBJECTIVES: We aim to assess the impact of early nocturnal blood pressure (BP) variation in the functional outcome of patients after an acute ischemic stroke. MATERIALS AND METHODS: We included consecutive stroke patients treated with intravenous thrombolysis (IVrtPA) in a tertiary stroke center. BP measurements were performed at regular intervals throughout day and night during the first 48 h after stroke onset, and subjects were divided into four dipping categories (extreme dippers, dippers, non-dippers, and reverse dippers). Recanalization was assessed by transcranial color-coded Doppler and/or angiographic CT. Hemorrhagic transformation was evaluated at 24 h follow-up CT scan. Functional outcome was evaluated at 3 months after stroke using the modified Rankin Scale. RESULTS: A total of 304 patients were included, mean age 72.80 ± 11.10 years. After 24 h of systolic BP monitoring, 30.59% were classified as reverse dippers, 39.14% as non-dippers, 19.10% as dippers, and 11.18% as extreme dippers. Multivariate analysis did not show an independent association of any dipping class with 3-month functional outcome. Hemorrhagic transformation was not uniform between dipping classes: 25.81% for reverse dippers, 14.29% for non-dippers, 15.52% for dippers, and 5.88% for extreme dippers, P = 0.033. CONCLUSIONS: Nocturnal BP dipping pattern is not associated with functional outcome at 3 months in acute stroke patients treated with IVrtPA. Hemorrhagic transformation was more frequent in reverse dippers.