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Browsing by Issue Date, starting with "2020-08"

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  • Sleep Apnea and Atrial Fibrillation - a Different Kind of Rhythm
    Publication . Sousa, S; Silva Cunha, P; Oliveira, MM; Drummond, M; Bugalho, A
    2020-08Journal article Open access Show more
  • Cytomegalovirus Colitis Mimicking Rectal Tumour in an Undiagnosed HIV Patient
    Publication . Rocha, M; Borges, V; Simões, G; Santos, S; Gamelas, V; Bernardes, C
    Introduction: Cytomegalovirus (CMV) is the most common opportunistic agent in HIV-infected patients. It can affect the entire gastrointestinal tract, but frequently involves the oesophagus and the colon. Case Report: We report the case of a 70-year-old female, ultimately diagnosed with HIV infection, whose inaugural clinical manifestation was CMV colitis with endoscopic findings resembling a rectal tumour in which initial histological evaluation was not able to provide a proper diagnosis. Discussion/Conclusion: Since clinical presentation is variable and histopathological yield without immunohistochemical analysis is poor, recognizing CMV infection in the absence of known risk factors may be difficult. It is crucial to consider this entity with suspicious lesions or when initial evaluation, either clinical or histopathological, is inconclusive, thus avoiding potentially debilitating and superfluous treatment or life-threatening complications.
    2020-08Journal article Open access Show more
  • Impact of Physical Activity and Exercise on Bone Health in Patients with Chronic Kidney Disease: a Systematic Review of Observational and Experimental Studies
    Publication . Cardoso, D; Marques, E; Leal, D; Ferreira, A; Baker, L; Smith, A; Viana, J
    Background: Chronic Kidney Disease (CKD) patients frequently develop life-impairing bone mineral disorders. Despite the reported impact of exercise on bone health, systematic reviews of the evidence are lacking. This review examines the association of both physical activity (PA) and the effects of different exercise interventions with bone outcomes in CKD. Methods: English-language publications in EBSCO, Web of Science and Scopus were searched up to May 2019, from which observational and experimental studies examining the relation between PA and the effect of regular exercise on bone-imaging or -outcomes in CKD stage 3-5 adults were included. All data were extracted and recorded using a spreadsheet by two review authors. The evidence quality was rated using the Cochrane risk of bias tool and a modified Newcastle-Ottawa scale. Results: Six observational (4 cross-sectional, 2 longitudinal) and seven experimental (2 aerobic-, 5 resistance-exercise trials) studies were included, with an overall sample size of 367 and 215 patients, respectively. Judged risk of bias was low and unclear in most observational and experimental studies, respectively. PA was positively associated with bone mineral density at lumbar spine, femoral neck and total body, but not with bone biomarkers. Resistance exercise seems to improve bone mass at femoral neck and proximal femur, with improved bone formation and inhibited bone resorption observed, despite the inconsistency of results amongst different studies. Conclusions: There is partial evidence supporting (i) a positive relation of PA and bone outcomes, and (ii) positive effects of resistance exercise on bone health in CKD. Prospective population studies and long-term RCT trials exploring different exercise modalities measuring bone-related parameters as endpoint are currently lacking.
    2020-08-08Journal article Open access Show more