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- The Prevalence of COVID-19 Fog and the Impact on Quality of Life After SARS-CoV-2 Infection (QoL-COVID)Publication . De Figueiredo, Inês Rego; Ferrão, Joana Branco; Dias, Sara; Borges, Diogo Drummond; Fernandes, Jorge; Bernardino, Vera; Gruner, Heidi; Panarra, António; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Biblioteca Nacional de Portugal, Centro de Estudos Históricos, CELOMIntroduction: Coronavirus has an impact on both the physical and mental health of individuals. The literature regarding the patient’s health status post- SARS-CoV-2 is still scarce with limited data on the prevalence of residual symptoms and quality of life (QoL) after the infection. The aim of this study was to understand the impact of SARS-CoV-2 on patient QoL, and remaining symptoms. Methods: Single center cross-sectional study of patients who had been admitted to our COVID-19 ward between March 2020 and March 2021. By applying a QoL questionnaire (EQ-5D-5L) we assessed the overall sample, at three time points and in different groups of patients: those admitted to the intensive care unit (ICU) and the elderly. Results: A total of 125 participants were included in our study. Most patients who were admitted had a severe course of disease (51%), with 22% of admissions to the ICU, with 8% requiring prone ventilation, 10% experiencing thrombotic complications and 18% of nosocomial infections throughout the admission. As for persistent symptoms related with COVID-19 fog, the most frequent were fatigue (57%), memory loss (52%) and insomnia (50%). Regarding QoL, the average decrease was 0.08 ± 0.2 in the index and 8.7 ± 19 in the Visual Analogue Scale (VAS). The QoL index decrease correlated with age, chronic obstructive pulmonary disease, asthma and heart failure, and all persistent symptoms, significantly. QoL VAS correlated significantly with fatigue, mood changes, difficulty concentrating and memory loss. The decrease in QoL and the persistent symptoms remained overall stable over the three time points. The ICU group showed no statistically significant difference in QoL, but the most frequently persistent symptoms were mood changes and attention disturbances. However, the elderly experienced a worsening in QoL expressed by index (0.69 ± 0.3 vs 0.8 ± 0.2, p-value = 0.01). Conclusion: A decrease in QoL was observed following SARS-CoV-2 infection, correlating with both chronic conditions and persistent symptoms. The lack of difference through time points of both QoL and persistent symptoms suggests a long-standing effect.
- Prematuridade e cardiopatia congénitaPublication . Laranjo, Sérgio Matoso; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Comprehensive Health Research Centre (CHRC) - pólo NMS; Sociedade Portuguesa de Cardiologia | Elsevier
- Canal arterialPublication . Laranjo, Sérgio Matoso; Laranjo, Sergio; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Comprehensive Health Research Centre (CHRC) - pólo NMS; Sociedade Portuguesa de Cardiologia | Elsevier
- Reproducibility and validity of the Portuguese Edmonton Frail Scale version in cardiac surgery patientsPublication . Castro, Maria de Lurdes; Alves, Marta; Martins, Ana; Luísa Papoila, Ana; Botelho, Maria-Amália; Botelho, Amalia; Fragata, José; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Sociedade Portuguesa de Cardiologia | ElsevierINTRODUCTION: Frailty is a multidimensional syndrome characterized by the loss of functional reserve, associated with higher mortality and less functional survival in cardiac surgery patients. The Edmonton Frail Scale (EFS) is a comprehensive tool devised for brief frailty detection. To the best of our knowledge, there are no culturally adapted and validated frailty screening tools that enable the identification of vulnerability domains suited for use in the preoperative setting in Portugal. This was the motivation for this study. OBJECTIVES: To assess the validity and reproducibility of the Portuguese version of the EFS. METHODS: Prospective observational study, in a sample of elective cardiac surgery patients. The Edmonton Frail Scale (EFS) translation and backtranslation were performed. Demographic and clinical data were collected, and the translated EFS translated, Geriatric Depression Scale, and Mini Mental State Examination Portuguese versions, Katz and Clinical Frailty Scales were administered. To assess validity Mann-Whitney test, Spearman's correlation coefficient, marginal homogeneity test and Kappa coefficient were employed. Reproducibility was assessed estimating kappa coefficient for the frailty diagnosis and the 11 EFS items. Intra-class correlation coefficients and the corresponding 95% confidence interval were estimated using linear mixed effects model. RESULTS: The EFS Portuguese version revealed construct validity for frailty identification, as well as criterion validity for cognition and mood domains. Reproducibility was demonstrated, with k=0.62 (95% confidence interval (CI) 0.42-0.82) and intraclass correlation (ICC)=0.94 (95% CI 0.89-0.97) in inter-observer test and k=0.48 (95% CI 0.26-0.70) and ICC=0.85 (95% CI 0.72-0.92) in intra-observer test. CONCLUSIONS: The EFS Portuguese version is valid and reproducible for use, suiting pre-operative frailty screening in a cardiac surgery setting.
- Proportion of patients without mental disorders being treated in mental health services worldwidePublication . Bruffaerts, Ronny; Posada-Villa, Jose; Al-Hamzawi, Ali Obaid; Gureje, Oye; Huang, Yueqin; Hu, Chiyi; Bromet, Evelyn J.; Viana, Maria Carmen; Hinkov, Hristo Ruskov; Karam, Elie G.; Borges, Guilherme; Florescu, Silvia E.; Williams, David R.; Demyttenaere, Koen; Kovess-Masfety, Viviane; Matschinger, Herbert; Levinson, Daphna; De Girolamo, Giovanni; Ono, Yutaka; De Graaf, Ron; Browne, Mark Oakley; Bunting, Brendan; Xavier, Miguel; Xavier, Miguel; Haro, Josep Maria; Kessler, Ronald C.; Kessler, Ronald; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Centro de Estudos de Doenças Crónicas (CEDOC); Royal College of Psychiatrists | Cambridge University PressBackground: Previous research suggests that many people receiving mental health treatment do not meet criteria for a mental disorder but are rather 'the worried well'. Aims: To examine the association of past-year mental health treatment with DSM-IV disorders. Method: The World Health Organization's World Mental Health (WMH) Surveys interviewed community samples of adults in 23 countries (n = 62 305) about DSM-IV disorders and treatment in the past 12 months for problems with emotions, alcohol or drugs. Results: Roughly half (52%) of people who received treatment met criteria for a past-year DSM-IV disorder, an additional 18% for a lifetime disorder and an additional 13% for other indicators of need (multiple subthreshold disorders, recent stressors or suicidal behaviours). Dose-response associations were found between number of indicators of need and treatment. Conclusions: The vast majority of treatment in the WMH countries goes to patients with mental disorders or other problems expected to benefit from treatment.
- Exequibilidade do estudo funcional respiratório em idade pré-escolar na prática clínicaPublication . Santos, N.; Almeida, I.; Couto, M.; Morais-Almeida, M.; Borrego, L. M.; BORREGO, LUIS MIGUEL; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Centro de Estudos de Doenças Crónicas (CEDOC); Elsevier DoymaIntroduction: The assessment of respiratory function in preschool children, which has recently been attracting considerable interest, has several methodological particularities. Whether this is feasible in clinical practice with large groups of patients still needs to be investigated. Aim: To assess the feasibility of pulmonary function testing in preschool children in clinical practice, and report the degree of success achieved according to age. Methods: Retrospective analysis of lung function tests performed in children from 2 to 6 years old at the respiratory function laboratory of CUF Descobertas Hospital between September 2006 and August 2011. Whole-body pletismography without occlusion for specific airway resistance (sRaw) assessment and animated spirometry were performed using the equipment Jaeger 4.65 (Viasys Healthcare), before and after 400. μg of inhaled salbutamol via a spacer device. The research fulfilled international criteria (ATS/ERS) for acceptability and reproducibility. Results: Of 1,239 lung function tests performed, 1,092 (88%) had acceptable and reproducible criteria for spirometry (children with a mean age of 4.3±0.91 years; 60.7% male), and 979 (79%) for sRaw measurement. We were able to report FEV1 in 801 (65%) tests (children with a mean age of 4.5±0.89 years). In 23 (2%) tests it was only possible to report FEV0.5 (children with a mean age of 3.5±0.67 years) and in 268 (22%) only FEV0.75 (children with a mean age of 4.0±0.89 years). Conclusion: Spirometry and sRaw assessment in preschool children can be used in clinical practice, with an increasing success rate as children get older. Reporting maneuvers of 0.5 or 0.75. seconds facilitates spirometric evaluation in a larger number of children.
- Effective radiation dose of three diagnostic tests in cardiologyPublication . De Araújo Gonçalves, Pedro; Sousa, Pedro Jerónimo; Calé, Rita; Marques, Hugo; Pinto Marques, Hugo; Dos Santos, Miguel Borges; Dias, André; Dores, Hélder; Dores, Helder; Carvalho, Maria Salomé; Ventosa, António; Martins, Teresa; Teles, Rui Campante; Almeida, Manuel; Mendes, Miguel; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Centro de Estudos de Doenças Crónicas (CEDOC); Sociedade Portuguesa de Cardiologia | ElsevierIntroduction: Diagnostic tests that use ionizing radiation play a central role in cardiology and their use has grown in recent years, leading to increasing concerns about their potential stochas-tic effects. The aims of this study were to compare the radiation dose of three diagnostic tests: single photon emission computed tomography (SPECT), invasive coronary angiography (ICA) and cardiac computed tomography (cardiac CT) and their evolution over time, and to assess the influence of body mass index on radiation dose. Methods: We assessed consecutive patients included in three prospective registries (SPECT, ICA and cardiac CT) over a period of two years. Radiation dose was converted to mSv and compared between the three registries. Differences over time were evaluated by comparing the first with the fourth semester. Results: A total of 6196 exams were evaluated: 35% SPECT, 53% ICA and 22% cardiac CT. Mean radiation dose was 10.7±1.2 mSv for SPECT, 8.1±6.4 mSv for ICA, and 5.4±3.8 mSv for cardiac CT (p<0.001 for all). With regard to the radiation dose over time, there was a very small reduction in SPECT (10.7 to 10.5 mSv, p=0.004), a significant increase (25%) in ICA (7.0 to 8.8mSv; p<0.001), and a significant reduction (29%) in cardiac CT (6.5 to 4.6 mSv, p<0.001). Obesity was associated with a significantly higher radiation dose in all three exams. Conclusions: Cardiac CT had a lower mean effective radiation dose than invasive coronary angiography, which in turn had a lower mean effective dose than SPECT. There was a significant increase in radiation doses in the ICA registry and a significant decrease in the cardiac CT registry over time.
- Evolução da capacidade funcional e estado de saúde dois anos após um programa de reabilitação respiratóriaPublication . Areias, V.; Ferreira, D.; Martins, A.; Matias, I.; Negrinho, F.; Rodrigues, F.; Centro de Estudos de Doenças Crónicas (CEDOC); NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Elsevier DoymaBackground: Pulmonary rehabilitation programs (PRP) have been shown to improve exercise capacity and health status and to reduce dyspnoea and use of healthcare resources, in patients with chronic lung disease. These benefits usually wane after the programs conclusion. Aim: Evaluate functional capacity and health status 2 years after the end of a PRP. Methods: Retrospective study of patients who took part in PRP. After PRP, patients who reported a physically active lifestyle were included in the active group (AG). The other patients were considered as the control group (CG). Functional capacity was evaluated with 6. minute walk distance (6MWD) and health status with St George's Respiratory Questionnaire (SGRQ). Results: Thirty-two patients were included, 24 in the AG and 8 in the CG. Immediately after PRP, there was a significant improvement in the 6MWD and SGRQ global score, for both groups. After completing PRP, in the AG, there was a decline in the mean 6MWD when evaluated at 6 months, 1 and 2 years and also in health status.However, after 2 years, the AG continued to show an average improvement of 32 m (p=0.03) in the 6MWD and at least 4 points in SGRQ compared to pre-PRP, while in the CG, there was a clinically significant decline in 6MWD (-34 m) and SGRQ score (13 points worse). Conclusion: Despite the progressive decline of benefits gained after completing PRP, in the AG these are still significantly positive after 2 years. An active lifestyle seems to help maintain the benefits of the Rehabilitation Program.
- Do rheumatologists have a role in health promotion among elderly?Publication . Rodrigues, A M; Maria Rodrigues, Ana; Branco, Jaime; Branco, Jaime; Canhão, H; Canhão, Helena; Centro de Estudos de Doenças Crónicas (CEDOC); NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Sociedade Portuguesa de Reumatologia
- Risk assessment in percutaneous coronary intervention and appropriate use criteriaPublication . Teles, Rui Campante; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); Centro de Estudos de Doenças Crónicas (CEDOC); Sociedade Portuguesa de Cardiologia | Elsevier