Repository logo

Browsing by Issue Date, starting with "2016-04"

Filter results by year or month
Now showing 1 - 10 of 11
  • Diagnostic Accuracy of Bone Turnover Markers and Bone Histology in Patients With CKD Treated by Dialysis
    Publication . Sprague, SM; Bellorin-Font, E; Jorgetti, V; Carvalho, AB; Malluche, HH; Ferreira, A; D'Haese, PC; Drüeke, TB; Du, H; Manley, T; Rojas, E; Moe, SM
    BACKGROUND: The management of chronic kidney disease-mineral and bone disorder requires the assessment of bone turnover, which most often is based on parathyroid hormone (PTH) concentration, the utility of which remains controversial. STUDY DESIGN: Cross-sectional retrospective diagnostic test study. SETTING & PARTICIPANTS: 492 dialysis patients from Brazil, Portugal, Turkey, and Venezuela with prior bone biopsy and stored (-20 °C) serum. INDEX TESTS: Samples were analyzed for PTH (intact [iPTH] and whole PTH), bone-specific alkaline phosphatase (bALP), and amino-terminal propeptide of type 1 procollagen (P1NP). REFERENCE TEST: Bone histomorphometric assessment of turnover (bone formation rate/bone surface [BFR/BS]) and receiver operating characteristic curves for discriminating diagnostic ability. RESULTS: The biomarkers iPTH and bALP or combinations thereof allowed discrimination of low from nonlow and high from nonhigh BFR/BS, with an area under the receiver operating characteristic curve > 0.70 but < 0.80. Using iPTH level, the best cutoff to discriminate low from nonlow BFR/BS was <103.8 pg/mL, and to discriminate high from nonhigh BFR/BS was >323.0 pg/mL. The best cutoff for bALP to discriminate low from nonlow BFR/BS was <33.1 U/L, and for high from nonhigh BFR/BS, 42.1U/L. Using the KDIGO practice guideline PTH values of greater than 2 but less than 9 times the upper limit of normal, sensitivity and specificity of iPTH level to discriminate low from nonlow turnover bone disease were 65.7% and 65.3%, and to discriminate high from nonhigh were 37.0% and 85.8%, respectively. LIMITATIONS: Cross-sectional design without consideration of therapy. Potential limited generalizability with samples from 4 countries. CONCLUSIONS: The serum biomarkers iPTH, whole PTH, and bALP were able to discriminate low from nonlow BFR/BS, whereas iPTH and bALP were able to discriminate high from nonhigh BFR/BS. Prospective studies are required to determine whether evaluating trends in biomarker concentrations could guide therapeutic decisions.
    2016-04Journal article Open access Show more
  • 2016-04Journal article Open access Show more
  • Hérnias Diafragmáticas
    Publication . Neves, C; Alcatrão, M; Gaspar, A; Bravo, A
    2016-04Journal article Open access Show more
  • Optical Coeherence Tomography: a Window to Multiple Sclerosis?
    Publication . Proença, R; Cardigos, J; Costa, L; Vicente, A; Santos, A; Amado, D; Ferreira, J; Cunha, JP
    Introduction: Multiple sclerosis (MS) is an inflammatory immune-mediated demyelinating disease that frequently affects the central nervous system. Approximately 20% of patients have optic neuritis has the first manifestation of the disease. Its frequency, heterogeneity and absence of definitive treatment make it a therapeutic and diagnostic challenge for both the patient and the clinician. Material and methods: Retrospective study of 133 eyes of 87 patients, 38 patients with MS (Group 1), 9 patients with isolated optic neuritis (Group 2) and 40 healthy patients (Group 3) from the Neurophthalmology Department of Centro Hospitalar de Lisboa Central from January 2013 to August 2015. Patients were characterized according to gender, age, years of follow-up, best corrected visual acuity, presence of other ocular disorders and episodes of optic neuritis. Patients with other ocular pathologies were excluded. Optical coherence tomography (OCT Spectralis, Heidelberg Engineering) of the macular region was done in all patients, followed by automatic segmentation of the retinal layer. Statistical tests were made to calculate statistically significant results between different groups. Results: Of the 87 patients evaluated, the mean age in Group 1 was 41.55 compared to 36.88 in Group 2 and 44.73 in the control group. Mean age of diagnosis for patients with MS was 33.73 years with a mean follow up of 8.01 years, whereas patients with isolated optic neuritis had a mean age of diagnosis of 34.33 years, with a mean follow-up of 2.88 years. Best corrected visual acuity ranged from 0.2 to 1.0 in Group 1 and 0.5 to 1.0 in Group 2. In patients with previous episodes of optic neuritis isolated or associated with multiple sclerosis we observed a statistically significant (p<0.05) reduction of the average retinal thickness as well as a thinner retinal nerve fiber layer, ganglion cell layer and inner plexiform layer when compared to the control group. Conclusion: Thickness of the internal retinal layers was reduced (retinal nerve, ganglion cell and inner plexiform layer) in a statistically significant value (p<0.05) when compared to the control group.
    2016-04Journal article Open access Show more
  • 2016-04Journal article Open access Show more
  • Sex-Specific Associations Between Coronary Artery Plaque Extent and Risk of Major Adverse Cardiovascular Events: The CONFIRM Long-Term Registry
    Publication . Schulman-Marcus, J; Hartaigh, B; Gransar, H; Lin, F; Valenti, V; Cho, I; Berman, D; Callister, T; DeLago, A; Hadamitzky, M; Hausleiter, J; Al-Mallah, M; Budoff, M; Kaufmann, P; Achenbach, S; Raff, G; Chinnaiyan, K; Cademartiri, F; Maffei, E; Villines, T; Kim, Y; Leipsic, J; Feuchtner, G; Rubinshtein, R; Pontone, G; Andreini, D; Marques, H; Shaw, L; Min, J
    OBJECTIVES: The purpose of this study was to examine sex-specific associations, if any, between per-vessel coronary artery disease (CAD) extent and the risk of major adverse cardiovascular events (MACE) over a 5-year study duration. BACKGROUND: The presence and extent of CAD diagnosed by coronary computed tomography angiography (CTA) is associated with increased short-term mortality and MACE. Nevertheless, some uncertainty remains regarding the influence of sex on these findings. METHODS: 5,632 patients (mean age 60.2 ± 11.8 years, 36.5% women) from the CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter) registry were followed for 5 years. Obstructive CAD was defined as ≥50% luminal stenosis in a coronary vessel. Using Cox proportional hazards models, we calculated the hazard ratio (HR) for incident MACE among women and men, defined as death or myocardial infarction. RESULTS: Obstructive CAD was more prevalent in men (42% vs. 26%; p < 0.001), whereas women were more likely to have normal coronary arteries (43% vs. 27%; p < 0.001). There were a total of 798 incident MACE events. After adjustment, there was a strong association between increased MACE risk and nonobstructive CAD (HR: 2.16 for women, 2.56 for men; p < 0.001 for both), obstructive 1-vessel CAD (HR: 3.69 and 2.66; p < 0.001), 2-vessel CAD (HR: 3.92 and 3.55; p < 0.001), and 3-vessel/left main CAD (HR: 5.94 and 4.44; p < 0.001). Further exploratory analyses of atherosclerotic burden did not identify sex-specific patterns predictive of MACE. CONCLUSIONS: In a large prospective coronary CTA cohort followed long-term, we did not observe an interaction of sex for the association between MACE risk and increased per-vessel extent of obstructive CAD. These findings highlight the persistent prognostic significance of anatomic CAD subsets as detected by coronary CTA for the risk of MACE in both women and men.
    2016-04Journal article Open access Show more
  • Instrumentos para Evaluación del Riesgo de Caídas en los Ancianos Residentes en la Comunidad
    Publication . Mota de Sousa, LM; Marques-Vieira, CM; Caldevilla, MN; Henriques, CM; Severino, S; Caldeira, S
    Las caídas y el riesgo de caer aumentan con la edad y con el grado de fragilidad asociado al envejecimiento, siendo este el motivo por el cual el riesgo de caídas es un fenómeno de interés para los enfermeros. En Portugal, la Dirección General de Salud recomienda la realización de pruebas de evaluación de la movilidad, la capacidad física y funcional. Objetivo: Identificar los instrumentos utilizados para evaluar el riesgo de caída en el anciano residente en la comunidad.Método: Revisión sistemática de la literatura, cumpliendo las recomendaciones del Joanna Briggs Institute a través de la utilización del método PICo y de las recomendaciones PRISMA. El método PICo ayudó a definir los criterios de inclusión: Muestra (P) - los ancianos; Área de Interés (I) - instrumentos y pruebas que permiten evaluar el riesgo de caídas, y Contexto (Co) - vivir en la comunidad. La consulta bibliográfica fue realizada a través de las bases de datos: EBSCOHost®, CINAHL Complete y MEDLINE Complete, y utilizando los términos; fall, community dwelling, fall risk factors y tools escale. Resultados: Fueron seleccionados 24 estudios, en los que se identificaron seis escalas que evaluaban el riesgo de caídas, tres el miedo de caer y siete que evaluaban factores de riesgo predictivos del riesgo de caída, en ancianos que residen en la comunidad. Conclusiones: Los resultados destacan el número de instrumentos disponibles y la importancia de la utilización práctica por parte de los enfermeros de instrumentos válidos, fidedignos y sensibles, de modo de obtener diagnósticos precisos.
    2016-04Journal article Open access Show more
  • 2016-04Other Open access Show more
  • Atypical Hemolytic Uremic Syndrome in Intensive Care: Case Report in an Adult
    Publication . Agudo, I; Souto-Moura, T; Azevedo, L; Cavaco, R; Germano, N; Bento, L
    2016-04Other Open access Show more
  • Fatores Explicativos da Apreciação de Filmes Cómicos em Pessoas com Doença Renal Crónica
    Publication . Mota de Sousa, LM; Marques-Vieira, CM; Severino, S; Rosado, J; José, H
    Objetivos: Identificar os factores que influenciam a apreciação de filmes humorosos em pessoas com doença renal crónica e conhecer os filmes humorosos mais apreciados por estas pessoas durante a sessão de hemodiálise. Métodos: Pesquisa descritiva e correlacional de delineamento transversal. Amostra randomizada composta por pessoas com doença renal crónica submetidas a hemodiálise numa clínica. A colheita de dados foi por meio de entrevista individual e questionário autopreenchido, utilizando-se os instrumentos: caracterização dos sujeitos e o formulário do sentido de humor. Os dados foram analisados recorrendo a procedimentos da estatística descritiva como média, desvio padrão e frequência simples e relativa e teste de hipóteses t student e qui quadrado para estabelecer a associação entre variáveis independentes e dependente. Resultados: Dos 171 participantes, os jovens e casados apreciam mais filmes de humor. As pessoas com doença renal crónica que apreciam filmes de humor consideram-se alegres e divertidas, referem ter sentido de humor e ter uma família divertida. Além disso, mencionam gostar de brincar, de rir, que as façam rir, de estar com pessoas com sentido de humor, de ouvir anedotas, de ler livros cómicos e de ouvir histórias engraçadas. Conclusões: Foram verificados os factores sociodemográficos e clínicos que estão relacionados com o sentido de humor e que influenciam a apreciação de filmes de humor, bem como foram identificados os principais tipos de filmes/vídeos de humor/cómicos apreciados pelas pessoas com doença renal crónica. Este estudo traz contributos importantes para a intervenção de enfermagem humor da Classificação das intervenções de enfermagem.
    2016-04Journal article Open access Show more