Browsing by Author "Henriques, C."
Now showing 1 - 8 of 8
Results Per Page
Sort Options
- Accuracy of ultrasound in the diagnosis of acute cholecystitis with coexistent acute pancreatitisPublication . Pereira, J.; Afonso, A.; Constantino, J.; Matos, A.; Henriques, C.; Zago, M.; Pinheiro, L.Acute cholecystitis and pancreatitis are acute forms of cholecystolithiasis. The presence of acute cholecystitis can lead to important changes in therapy in the early course of acute pancreatitis. The aim of this study was to identify the accuracy of ultrasonography in diagnosing acute cholecystitis with coexistent acute pancreatitis.
- Cardiopatia isquémica e diabetesPublication . Saraiva, L.; Adolfo, D.; Oliveira, M.; Almeida, H.; Matos, A.; Henriques, C.; Correia, J.A diabetes mellitus é um dos distúrbios metabólicos mais comuns no mundo, as complicações a longo prazo manifestam-se na forma de doença micro e macrovascular, nomeadamente doença cardiovascular (DCV). A associação da diabetes e DCV está demonstrada estimando-se que dos doentes com síndrome coronário agudo (SCA), 24-30% são diabéticos. O presente estudo pretende caracterizar os doentes com DCV de forma a determinar a existência de um padrão, entre os doentes diabéticos que permita antecipar e prevenir a ocorrência do SCA, para futuramente criar um algoritmo de seguimento. Selecionaram-se aleatoriamente doentes inscritos na consulta de diabetes de um hospital, que cumpriam os critérios de inclusão: mais de 45 anos, diabetes tipo 2, história de SCA ou rastreio cardíaco positivo. Foram avaliadas as seguintes características há data do SCA ou do rastreio positivo: idade, sexo, IMC, glicémia, HbA1c, comorbilidades, terapêutica antidiabética e coadjuvante usada antes e depois, exames complementares de diagnóstico realizados, extensão da doença coronária. Análise estatística em SPSS versão 22. Os resultados preliminares revelaram que entre os 50 doentes selecionados, 66% eram homens e 34% mulheres, dos quais 38 tiveram um único SCA ou rastreio positivo, enquanto 12 deles tiveram múltiplos eventos. Entre os primeiros, o estudo foi realizado por rastreio cardíaco em 36,8%, por angina estável em 5,3%, por angina instável em 13,2% e por EAM em 42,1%. Em suma os resultados preliminares indicam que os doentes que apresentam um SCA ou rastreio cardíaco positivo têm em média entre 59,6 a 63 anos, uma duração de entre os 12 e os 13,2 anos, um IMC que varia entre 28,3 e 26,56 Kg/m2, uma HbA1c entre 8,0 e 7,9%, uma glicémia no evento entre 210,7 e 242 mg/dL. Entre 62,2 e 63,2% apresentam concomitantemente HTA. Os doentes com eventos múltiplos têm um risco acrescido de recidiva da doença coronária, sendo os tratamentos, nomeadamente de revascularização, menos eficazes.
- Criteria to predict carriers of a novel SCN5A mutation in a large Portuguese family affected by the Brugada syndromePublication . Santos, L. F.; Rodrigues, B.; Moreira, D.; Correia, E.; Nunes, L.; Costa, A.; Elvas, L.; Pereira, T.; Machado, J. C.; Castedo, S.; Henriques, C.; Matos, A.; Santos, J. O.Brugada syndrome (BrS) is a life-threatening arrhythmia disorder associated with autosomal-dominant mutations in the SCN5A gene. We aimed to characterize the diagnostic challenges and clinical manifestations of a novel SCN5A mutation associated with BrS.
- Derivation and validation of the SLE Disease Activity Score (SLE-DAS): a new SLE continuous measure with high sensitivity for changes in disease activityPublication . Jesus, Diogo; Cristina Bico Rodrigues de Matos, Ana; Henriques, C.; Zen, Margherita; Larosa, Maddalena; Iaccarino, Luca; Da Silva, José António Pereira; Doria, Andrea; Inês, Luís SousaObjectives To derive and validate a new disease activity measure for systemic lupus erythematosus (SLE), the SLE Disease Activity Score (SLE-DAS), with improved sensitivity to change as compared with SLE Disease Activity Index (SLEDAI), while maintaining high specificity and easiness of use. Methods We studied 520 patients with SLE from two tertiary care centres (derivation and validation cohorts). At each visit, disease activity was scored using the Physician Global Assessment (PGA) and SLEDAI 2000 (SLEDAI-2K). To construct the SLE-DAS, we applied multivariate linear regression analysis in the derivation cohort, with PGA as dependent variable. The formula was validated in a different cohort through the study of: (1) correlations between SLE-DAS, PGA and SLEDAI-2K; (2) performance of SLEDAI-2K and SLE-DAS in identifying a clinically meaningful change in disease activity (ΔPGA≥0.3); and (3) accuracy of SLEDAI-2K and SLE-DAS time-adjusted means in predicting damage accrual. Results The final SLE-DAS instrument included 17 items. SLE-DAS was highly correlated with PGA (r=0.875, p<0.0005) and SLEDAI-2K (r=0.943, p<0.0005) in the validation cohort. The optimal discriminative ΔSLE-DAS cut-off to detect a clinically meaningful change was 1.72. In the validation cohort, SLE-DAS showed a higher sensitivity than SLEDAI-2K (change ≥4) to detect a clinically meaningful improvement (89.5% vs 47.4%, p=0.008) or worsening (95.5% vs 59.1%, p=0.008), while maintaining similar specificities. SLE-DAS performed better in predicting damage accrual than SLEDAI-2K. Conclusion SLE-DAS has a good construct validity and has better performance than SLEDAI-2K in identifying clinically significant changes in disease activity and in predicting damage accrual.
- A ecografia como instrumento de diagnóstico – um caso de estudoPublication . Matos, A.; Henriques, C.; Pereira, J.; Afonso, A.; Constantino, J.Equipas interdisciplinares estão na base do sucesso de muitos trabalhos de investigação. Um exemplo disso é a colaboração da estatística com as ciências da saúde. Neste trabalho, recorrendo a testes não paramétricos e a modelos de regressão logística, foi possível contribuir para o conhecimento da não acuidade, da ecografia no diagnóstico de colecistite aguda na presença de pancreatite aguda. Deste modo, este estudo contribui para um melhor diagnóstico clínico que será determinante na terapêutica a adotar.
- Morbidity and mortality in preterm infants less than 29 weeks of gestational agePublication . Marques, B.R.; Dinis, A.C.; Rocha, G.; Flôr-de-Lima, F.; Matos, Ana; Henriques, C.; Guimarães, H.Background: Preterm birth is certainly a public health problem. Aside from being an important cause of mortality, prematurity increases the risk of serious lifetime disabilities. Objective: To assess the overall survival, causes of death and neonatal morbidities associated with prematurity of newborns less than 29 weeks of gestational age (GA). Methods: Retrospective study including all preterm infants less than 29 weeks of GA admitted to the level III Neonatal Intensive Care Unit (NICU) at Centro Hospital São João in Porto, Portugal, between January 1st, 2005 and December 31st, 2016. Newborns were grouped into three groups according to their GA: G23+0-24+6, G25+0-26+6, G27+0-28+6. Results: In this 12-year-period, 160 preterm neonates less than 29 weeks of GA admitted to this NICU met our inclusion criteria. Overall deaths were 60 (37.5%), variating between 25 (92.6%) in the G23+0-24+6, 23 (46%) in the G25+0-26+6 and 12 (14.5%) in the G27+0-28+6. The leading causes of death were intraventricular hemorrhage (IVH) and sepsis. Early neonatal mortality was 20.6%. Among survivors, 41% had bronchopulmonary dysplasia (BPD), 69% developed late sepsis, 56% retinopathy of prematurity (ROP), 44% IVH and 10% cystic periventricular leukomalacia (cPVL). Conclusions: Mortality rates in this preterm group were high in spite of all the technological and scientific advances. Pulmonary conditions (respiratory distress syndrome and BPD), sepsis and neurologic outcomes (ROP, IVH and cPVL) were still major causes of morbidity. In line with other series, the limit of viability in this cohort of preterm infants is 25 weeks of GA. Prenatal, perinatal and postnatal care still all have a long road ahead, especially when it comes to these “gray zone” newborns.
- Playfulness and communication for children with autism spectrum disorder: guidelines for a videogamePublication . Alves, Valter; P. Duarte, Rui; Fonseca, F.; Bernardo, Marco V.; Barreto, Pedro; Silva, C.E.; Felizardo, Sara; Videira, I.; Matos, A.; Henriques, C.Autism Spectrum Disorder (ASD) affects sensory processing and conditions the development of communication skills and social interaction. Literature shows that children with ASD are fond of technologies and videogames in particular. The predictable and constant behaviour of technological components, the visual appeal, and the challenges are often highly appreciated (Zakari et al., 2014). Besides, videogames typically allow users to play alone, which is adequate to the profile of such an audience. The use of videogames by autistic children has shown to be relevant, and studies are evidencing gains in several areas (Malinverni et al., 2017; Hedges et al., 2018; Ng & Pera, 2018; Valencia et al., 2019; Baldassarri et al., 2020). Even so, existing solutions that were specifically developed for this audience have assumedly pedagogical goals, which systematically compromises their ludic dimension (Hirsh-Pasek et al., 2015). A study is being developed to design and implement a videogame that focuses on pure playfulness and provides an advantage to players who adopt specific strategies that rely on communicating with other players. This videogame is conceived for both intervention and research. The game mechanics explores the flow theory (Csikszentmihalyi, 2011), in order to dynamically adapt the challenges to the skills shown by the players, trying not to let them reach states of anxiety (due to lack of skills) or boredom (due to lack of challenge). This reasoning is extended to motor skills, as autistic people may have difficulties. In this context, it is important to clarify that the study is limited to children with ASD without associated intellectual development disorders that compromise the viability of the very act of playing. Also instrumental to the project, different scenarios are designed so that researchers can observe and collect scientific data, aiming at better understanding the related issues. Such scenarios support the analysis of the influence of physical proximity between the players, their prior level of familiarity, and their relative communicational abilities. Also under analysis is the impact of repeating the experience, both in terms of in-game performance and regarding a possible contribution to the relationship between participants and, eventually, with third parties. The core of this paper is the presentation of the design guidelines that were created to support the videogame. The guidelines result from the contributions of experts, organised according to a Delphi technique (Green, 2014). The set of experts cover the fields of ASD, game design, special education, occupational therapy, rehabilitation, and educational research. Also included is the description of the videogame development, which resorts to agile methodologies, allowing for an incremental and iterative production, supported by recurrent tests and consistently validated according to the intended objectives.
- Statistics in medicine: case studiesPublication . Matos, A.; Henriques, C.ABSTRACT. Successful research involves the creation of interdisciplinary teams. The collaboration of statisticians and physicians is an example. In this talk we will show two case studies. The first shows how it was possible to contribute to concede the non accuracy of ultrasonography in the diagnosis of acute cholecystitis in the presence of acute pancreatitis and thus contribute to a better clinical diagnosis that will determine the therapy to adopt. The study enrolled 120 patients with acute pancreatitis. The patients were divided into two groups: the first group of patients for whom the result of the ultrasonography was negative for acute cholecystitis (77 patients); the second group included the patients with positive result in the ultrasonography (43 patients). Statistical analyzes were conducted illustrating the inaccuracy of ultrasonography alone in the diagnosis of acute cholecystitis [1]. The second case involves an observational study of protein expression, human hepcidin, in liver tissue of patients with alcoholic liver disease (DHA) and of healthy individuals. It involved 61 patients with DHA and 20 healthy controls. This work contributes to a better clarification of the mechanism that stimulates increased iron levels in patients with DHA. This talk is based in joint work with Carla Henriques of the Polytechnic Institute of Viseu, Jorge Pereira, Catarina Afonso and Luis Matos Costa of the Tondela-Viseu Hospital Center.