Porto biomedical journal最新文献

{"title":"Occurrence and predictors of delirium in critically ill older patients: a prospective cohort study.","authors":"Rita Martins, Sónia Martins, Raquel Correia, Elika Pinho, Cristiana Paulo, Maria João Silva, Ana Teixeira, Liliana Fontes, Luís Lopes, José Artur Paiva, Luís Filipe Azevedo, Lia Fernandes","doi":"10.1097/j.pbj.0000000000000240","DOIUrl":"10.1097/j.pbj.0000000000000240","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to analyze the occurrence of delirium in critically ill older patients and to identify predictors of delirium.</p><p><strong>Methods: </strong>This prospective study included critically ill older patients admitted into level II units of Intensive Care Medicine Department of a University Hospital. Patients with Glasgow Coma Scale score ≤11, traumatic brain injury, terminal disease, history of psychosis, blindness/deafness, or inability to understanding/speaking Portuguese were excluded. The Confusion Assessment Method-Short Form (CAM-4) was used to assess the presence of delirium.</p><p><strong>Results: </strong>The final sample (n = 105) had a median age of 80 years, most being female (56.2%), widowed (49.5%), and with complete primary education (53%). Through CAM-4, 36.2% of the patients had delirium. The delirium group was more likely to have previous cognitive decline (48.6% vs 19.6%, <i>P</i> = .04) and severe dependency in instrumental activities of daily living (34.3% vs 14.8%, <i>P</i> = .032), comparing with patients without delirium. The final multiple logistic regression model explained that patients with previous cognitive decline presented a higher risk for delirium (odds ratio: 4.663, 95% confidence Interval: 1.055-20.599, <i>P</i> = .042).</p><p><strong>Conclusions: </strong>These findings corroborate previous studies, showing that cognitive decline is an independent predictor for delirium in older patients. This study is an important contribution for the knowledge regarding the predictors of delirium. The recognition of these factors will help to identify patients who are at high risk for this syndrome and implement early screening and prevention strategies. However, further studies with larger samples, recruited from other clinical settings as well as analyzing other potential factors for delirium, will be needed.</p>","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 6","pages":"e240"},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous gastrostomies in advanced cancer.","authors":"José António Ferraz-Gonçalves, Susana Amaral, Filipa Pereira, Lígia Rodrigues Santos, José Guilherme Assis, Sérgio Alves, Diana Martins","doi":"10.1097/j.pbj.0000000000000238","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000238","url":null,"abstract":"<p><strong>Introduction: </strong>Gastrostomies can be performed percutaneously by interventional radiology (PRG) or endoscopy (PEG).</p><p><strong>Methods: </strong>Retrospective analysis of patients with advanced cancer who underwent a gastrostomy in 2017 in an oncology center.</p><p><strong>Results: </strong>In 2017, 164 patients underwent gastrostomies, and 137 (84%) were male. The median age was 60 years (range: 38-91). The predominant Eastern Cooperative Oncology Group (ECOG) performance status stage was 1, with 73 (45%) patients. Head and neck cancer was the most common diagnosis, with 127 (77%) cases. The most frequent reason for performing a gastrostomy was dysphagia, 132 (81%). Most gastrostomies were PEG, 121 (74%), followed by PRG, 41 (25%), and surgery, 2 (1%). Early complications occurred in 86 (52%) patients, and the most frequent of them were local pain in 69 (80%) patients and minor local bleeding in 13 (15%). Late complications occurred in 90 (55%) patients, and the most frequent was also local pain in 57 (63%) patients, followed by local infection in 8 (9%), tube extrusion in 7 (8%), and stomal leakage in 7 (8%). In the multivariable analysis, the factors associated with survival were lymph node metastases and the ECOG performance status. Until June 30th, 2022, 123 (75%) patients had died, and 41 (25%) were still alive.</p><p><strong>Conclusion: </strong>Gastrostomies were performed predominantly in ECOG performance stage 1 patients with head and neck cancer and symptoms of dysphagia, and PEG was the most common procedure.</p>","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 6","pages":"e238"},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic kidney disease prevalence in asymptomatic patients with risk factors-usefulness of serum cystatin C: a cross-sectional study.","authors":"Mariela N Avila, María C Luciardi, Ana V Oldano, Mariano N Aleman, Rossana C Pérez Aguilar","doi":"10.1097/j.pbj.0000000000000233","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000233","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease is recognized as a worldwide public health problem, particularly within an increasing prevalence of obesity, diabetes mellitus, and hypertension. This disease affects more than 13% of the world's population and is increasing. Further biochemical assessment with new biomarkers, such as serum cystatin C (CysC), would improve patient care and disease control. The aim of this study was to detect chronic kidney disease (CKD) in asymptomatic subjects with risk factors and evaluate CysC as early biomarker of renal damage and accurate test to estimation glomerular filtration (GF).</p><p><strong>Methods: </strong>This observational analytic and cross-sectional design included 195 patients of both sexes. A full clinical evaluation included height, weight, waist circumference, body mass index (BMI), blood pressure (BP), and family history of disease. Renal function was evaluated through serum creatinine (SCrea), serum CysC, urinary albumin, and urinary creatinine. GF was calculated using CKD-EPI creatinine (CKD-EPI Crea) and CKD-EPI creatinine-cystatin C equations (CKD-EPI Crea-CysC).</p><p><strong>Results: </strong>Renal injury showed 24% of patients with albuminuria; 18% of them were categorized as A2 and 6% as A3. Therefore, 73% had no progression risk (baseline risk), 20% moderate risk, and 7% high risk. Among analyzed groups, significant differences were found in BMI, BP, Screa, CysC, CKD-EPI Crea, and CKD-EPI Crea-CysC. Overweight population was analyzed by assessing CysC and calculating CKD-EPI Crea-CysC, showing an important change with respect to the general population.</p><p><strong>Conclusion: </strong>Combined CysC and Crea measurement provides incremental improvement in predicting measured GF.</p>","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 6","pages":"e233"},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What do health care professionals, students, and laypeople in Greece believe about informed consent for research on medical practices? Unleashing Pandora's box.","authors":"Vaitsa Giannouli","doi":"10.1097/j.pbj.0000000000000236","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000236","url":null,"abstract":"<p><strong>Background: </strong>Attitudes toward informed consent for research on medical practices has been little investigated in Greece in the general population as well as in health care students and professionals, and at the same time, undergraduate and postgraduate curricula with focus on informed consent issues are entirely missing.</p><p><strong>Methods: </strong>To explore attitudes toward informed consent for research on medical practices among students, doctors, and laypeople in Greece across several demographic variables. A total of 380 participants (180 first-year healthcare university students from various faculties including medicine, pharmacy, biology, nursing, physiotherapy, midwifery, health care engineers, 100 medical doctors of various specialties working in hospitals and private practice, and 100 laypeople) completed a survey questionnaire along with a detailed demographics questionnaire.</p><p><strong>Results: </strong>The results revealed that between the three groups, there were statistically significant differences in the responses for all aspects of attitudes toward informed consent. Overall, Greek participants reported more negative attitudes when compared with findings from the United States. In addition, most of the participants reported lack of educational experience regarding informed consent.</p><p><strong>Conclusion: </strong>The findings showed that the efforts and relevant initiatives by the Greek State, private institutions, and the Greek Medical Societies should refocus and emphasize on educational programs concerning the dissemination of relevant scientific information on informed consent processes, either as a provider or as a consumer. Future research should further investigate in more depth the complex influence of additional social and/or psychological factors for the reported differences.</p>","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 6","pages":"e236"},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ANCA-associated vasculitis: overview and practical issues of diagnosis and therapy from a European perspective.","authors":"Ana Catarina Duarte, Rui Ribeiro, Ana M Macedo, Maria José Santos","doi":"10.1097/j.pbj.0000000000000237","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000237","url":null,"abstract":"<p><p>Antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) is a heterogeneous group of rare diseases characterized by necrotizing inflammation predominantly of small vessels and the presence of these circulating antibodies. AAV comprises three important diseases, namely granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis, which affect multiple organ systems, significantly affecting patients' quality of life and survival. The diagnosis is established according to the clinical manifestations, detectable ANCA, and histopathology findings. Primary treatment strategies are adapted to the severity of the disease and based on immunosuppression with corticosteroids and cyclophosphamide, with increasing adoption of new, less toxic agents aimed at sustained remission of the disease, such as rituximab, methotrexate, and mycophenolate mofetil. Several international medical organizations have proposed recommendations for diagnosing and managing these diseases to standardize the procedures. In this study, we provide an up-to-date European perspective on AAV management, compiling current and relevant information regarding its epidemiology, symptoms, diagnosis, treatment strategies, and prognosis.</p>","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 6","pages":"e237"},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seroprevalence of antibodies against SARS-CoV-2 among health care workers in a Portuguese hospital.","authors":"Rogério Ruas, Pedro Palma, Fátima Lamas, Anunciação Ruivo, Rui Malheiro, Rita Ferraz","doi":"10.1097/j.pbj.0000000000000239","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000239","url":null,"abstract":"<p><strong>Background: </strong>Health care workers (HCW) are presumably exposed to a higher risk of infection by SARS-CoV-2 and could possibly represent a source of transmission to susceptible patients. Thus, characterization of SARS-CoV-2 infection among HCW is necessary to better understand the determinants of viral transmission and properly implement strategies to prevent dissemination and protect HCW and vulnerable patients. The aim of this study was to estimate the seroprevalence of antibodies against SARS-CoV-2 in a Portuguese tertiary hospital, in the period of July 2020 to March 2021, before the generalized use of the SARS-CoV-2 vaccine, characterize its evolution over time, and identify risk factors associated with seroconversion.</p><p><strong>Methods: </strong>HCW were approached to collect serum samples for qualitative SARS-CoV-2 antibody testing and completion of an online survey capturing demographics, previous symptoms, and details of health care and community exposure. Odds ratio with bivariable and multivariable logistic regression was used to assess characteristics associated with seroprevalence.</p><p><strong>Results: </strong>One thousand HCW were included for analysis. Two hundred nineteen HCW (22%) were seropositive for immunoglobulin G against SARS-CoV-2, and 166 (17%) were seropositive for immunoglobulin M, most of whom reported a previous diagnosis of SARS-CoV-2 infection. The risk factors associated with seroconversion included a previous COVID-19 diagnosis, contact with patients, occupational contact with colleagues, and outside contact. However, in a multivariate logistic regression analysis, only a previous diagnosis and outside contact were associated with seroconversion. Seropositivity decreased over time, especially 28 weeks after infection.</p><p><strong>Conclusion: </strong>HCWs have a high seroprevalence for SARS-CoV-2 infection, probably due to a combination of health care and community exposure. Seropositivity decreases over time, but further studies are needed to better understand our adaptive immune response.</p>","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 6","pages":"e239"},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dieulafoy-like lesion after cold forceps biopsy: a rare complication from routine practice","authors":"R. Medas, Mariana L Matos, Amadeu C. R. Nunes, Guilherme Macedo","doi":"10.1097/j.pbj.0000000000000241","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000241","url":null,"abstract":"","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139295725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for hemoglobin disorders and investigating their hematological and demographic profile among patients attending a tertiary-care hospital in southern India-a descriptive study.","authors":"Dheebika Kuppusamy, Kolar Vishwanath Vinod, Rakhee Kar","doi":"10.1097/j.pbj.0000000000000271","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000271","url":null,"abstract":"<p><strong>Background: </strong>Hemoglobinopathies and thalassemias are widely prevalent autosomal inherited recessive disorders of the structure and synthesis of hemoglobin, respectively. Given the regional heterogeneity of these disorders, this study was undertaken to elucidate the patterns and prevalence of these disorders from this region.</p><p><strong>Methods: </strong>This was a tertiary-care hospital-based study in southern India over 4 years. Screening for hemoglobin (Hb) disorders was done using Hb high-performance liquid chromatography in patients based on initial screening of complete blood count parameters and for clinically indicated cases.</p><p><strong>Results: </strong>A normal Hb HPLC pattern was observed in 404 (72.1%) and abnormal in 156 (27.9%) of 560 cases studied. The abnormalities seen were heterozygous β-thalassemia in 73 (46.8%), homozygous β-thalassemia in 19 (12.2%), heterozygous α-thalassemia in 7 (4.5%), HbH disease and heterozygous δβ-thalassemia in 1 (0.6%) each, sickle cell trait in 9 (5.8%), sickle cell anemia in 8 (5.1%), sickle β-thalassemia in 17 (10.9%), HbS+ Hb D-Punjab in 1 (0.6%), heterozygous HbE in 6 (3.8%), homozygous HbE in 2 (1.3%), HbE β-thalassemia in 3 (1.9%), Hb J-Meerut in 1 (0.6%), Hb Kirksey in 4 (2.6%), unknown α-hemoglobinopathy in 2 (1.3%), and Hb Lepore in 2 (1.3%) cases. Most of the patients were from the neighboring districts, and some were referred from other states.</p><p><strong>Conclusion: </strong>The most common hemoglobin disorders were heterozygous β-thalassemia in 73 cases (46.8%) and sickle hemoglobinopathy in 35 cases (22.4%). A heterogeneous group of hemoglobin disorders, including uncommon α-hemoglobinopathies, was found in the study population, likely due to the referral of patients from various regions.</p>","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"9 5","pages":"271"},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare simulation-Past, Present, and Future.","authors":"Abel Nicolau, Joana Berger-Estilita, Willem L van Meurs, Vitor Lopes, Marc Lazarovici, Cristina Granja","doi":"10.1097/j.pbj.0000000000000270","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000270","url":null,"abstract":"","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"9 5","pages":"270"},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rectal pneumatosis close to a colorectal anastomosis unmasked by cystic spaces in a cold snare resection defect.","authors":"Vincent Zimmer","doi":"10.1097/j.pbj.0000000000000227","DOIUrl":"10.1097/j.pbj.0000000000000227","url":null,"abstract":"To the Editor: A 59-year-old male patient was referred by a collaborating endoscopist for a second opinion concerning questionable polypoid lesions in the rectum just below a colorectal anastomosis with essentially normal mucosal biopsies. Of note, history included subtotal colectomy due to colon cancer and multiple advanced polyps in the setting of MYH-associated polyposis (MAP). Recent colonoscopy revealed some subepithelial lesions in the upper rectum with firm consistency on forceps palpation (Fig. 1A). Meticulous endoscopic assessment indicated smooth surface with normal mucosal and vessel pattern. (Fig. 1B—not shown ancillary linked color imaging and blue laser imaging characterization) To unequivocally clarify the nature of the lesions, cold snare resection (or, in the case of a truly solid subepithelial lesion, “decaptation” to allow for deep biopsies) was performed without complications. Intriguingly, visualization of the resection bed, apparently enough reaching the submucosal space, demonstrated multiple intramural cystic","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 5","pages":"e227"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/46/29/pj9-8-e227.PMC10575352.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41241938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}