Browsing by Author "Matos, A."
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- 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.
- 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.
- Human and animal dermatophytosis: is it a real Public Health issue?.Publication . Matos, A.; Santos, C.; Vala, Helena; Esteves, F.; Oliveira, A. L.; Cruz, R.; Mega, A. C.; Nóbrega, C.; Mesquita, J. R.
- OP0147 THE SLE-DAS REMISSION AND LOW DISEASE ACTIVITY STATES DISCRIMINATE DRUG FROM PLACEBO AND BETTER HEALTH-RELATED QUALITY OF LIFE: POST-HOC ANALYSIS OF THE BLISS-52 AND BLISS-76 PHASE III TRIALS.Publication . Jesus, D.; Henriques, Carla; Matos, A.; Doria, A.; Inês, L.Background Accurate and practical outcome measures for clinical trials in systemic lupus erythematosus (SLE) are lacking. The SLE Disease Activity Score (SLE-DAS) is a recently validated 17-item instrument, with high accuracy and sensitivity to changes in SLE disease activity. The SLE-DAS definitions of remission and low disease activity (LDA) were newly validated in the clinical setting1,2. These definitions may constitute accurate and easy to apply endpoints for SLE trials. Objectives (1) To evaluate the ability of SLE-DAS remission and LDA definitions to discriminate drug from placebo in SLE phase 3 trials; (2) To determine if attainment of these SLE-DAS targets are associated with better health-related quality of life (HR-QoL). Methods Post-hoc analysis of the merged study population in the BLISS-52 and -76 trials (NCT00424476; NCT00410384) of intravenous belimumab versus placebo for moderate to severe SLE disease activity. We analyzed the British Isles Lupus Assessment Group (BILAG), Physician Global Assessment (PGA), Functional Assessment of Chronic Illness Therapy (FACIT) and 36-Item Short Form Survey (SF-36) trial data. The fulfillment of SLE-DAS remission and LDA definitions were retrospectively assessed from the individual participants’ data. Proportion of patients attaining SLE-DAS Boolean remission (defined as absence of all SLE-DAS clinical items and prednisone ≤5mg/day) and LDA (defined as SLE-DAS≤2.48 and prednisone ≤7.5mg/day), at week 52, was compared between belimumab and placebo arms, using likelihood ratio chi-square test. We further compared the SF-36 physical component summary (PCS) and mental component summary (MCS) and domain scores and the FACIT score between patients attaining SLE-DAS remission vs non-remission and SLE-DAS LDA vs non-LDA, using t-test and Mann-Whitney test. Results A total of 1684 SLE patients were included: 562 on placebo, 559 on belimumab 1mg/Kg and 563 on belimumab 10mg/Kg. At week 52, significantly more patients attained SLE-DAS LDA on belimumab 1mg/Kg and 10mg/Kg as compared with placebo (13.0% vs 17.9%, OR=1.459, p=0.023, and 13.0% vs 21.7%, OR=1.853, p<0.001, respectively). Likewise, more patients attained SLE-DAS remission on belimumab 10mg/Kg as compared with placebo (10.1% vs 14.7%, OR= 1.532, p=0.019) (Table 1). Importantly, none of the patients achieving SLE-DAS remission or LDA presented a new BILAG A or more than 1 new B domain score, neither a worsening in PGA≥0.3. Conclusion The SLE-DAS remission and LDA showed discriminant validity for identifying patients receiving active drug in clinical trials. These treatment targets are associated with better HR-QoL and lower fatigue.
- 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.
- POS0119 SLE-DAS REMISSION AND LOW DISEASE ACTIVITY STATES ARE ASSOCIATED WITH IMPROVED HEALTH-RELATED QUALITY OF LIFE AND FATIGUE: POST-HOC ANALYSIS OF THE BLISS-52 AND BLISS-76 PHASE III TRIALS.Publication . Jesus, D.; Matos, A.; Henriques, Carla; Doria, A.; Inês, L.Background Accurate and practical outcome measures for clinical trials in systemic lupus erythematosus (SLE) are lacking. The SLE Disease Activity Score (SLE-DAS) is a recently validated 17-item instrument, with high accuracy and sensitivity to changes in SLE disease activity. The SLE-DAS definitions of remission and low disease activity (LDA) were newly validated against disease activity physician-applied measures in the clinical setting [1, 2]. Criterion validity of SLE-DAS for Patient Reported Outcomes, namely health-related quality of life (HR-QoL) and fatigue needs to be assessed. Objectives To evaluate if the attainment of SLE-DAS remission and LDA states is associated with improvements in HR-QoL and fatigue. Methods Post-hoc analysis of the merged study population in the BLISS-52 and -76 trials (NCT00424476; NCT00410384) of intravenous belimumab versus placebo for moderate to severe SLE disease activity. We analysed the Functional Assessment of Chronic Illness Therapy (FACIT) and 36-Item Short Form Survey (SF-36) trial data. Fulfillment of SLE-DAS remission (defined as absence of all SLE-DAS clinical items and prednisone ≤5mg/day) and LDA (defined as SLE-DAS≤2.48 and prednisone ≤7.5mg/day) definitions were retrospectively assessed from the individual participants’ data. Mean changes from study baseline to week 52 in FACIT and SF-36 physical component summary (PCS) and mental component summary (MCS) and domain scores were compared between patients attaining at week 52 the SLE-DAS remission vs non-remission and the SLE-DAS LDA vs non-LDA using multivariate regression analysis adjusted for baseline scores. Results A total of 1684 SLE patients were included. Few patients were in SLE-DAS remission (0.5%) and LDA (0.8%) at study entry. At week 52, 12.5% patients attained SLE-DAS remission and 17.5% attained SLE-DAS LDA. Mean improvements in SF-36 PCS and MCS scores were greater in patients that attained SLE-DAS remission vs non-remission (5.4 vs 3.4, and 4.6 vs 2.7, respectively; multivariate p<0.005 for both) and SLE-DAS LDA vs non-LDA (5.0 vs 3.4 and 4.6 vs 2.6, respectively; multivariate p<0.005 for both), at week 52 (Figure 1). Similarly, improvements in all individual domain scores were greater in SLE-DAS remission vs non-remission patients (all multivariate p<0.005) and SLE-DAS LDA vs non-LDA patients (all multivariate p<0.005) (Figure 1). Importantly, improvements in the summary scores and in all the individual domain scores largely exceeded the minimum clinically important differences (MCIDs) of 2.5 and 5 points, respectively, in those patients attaining SLE-DAS remission or LDA. Additionally, mean improvements in FACIT scores were higher in SLE-DAS remission than non-remission (6.3 vs 3.6, multivariate p<0.001) and in SLE-DAS LDA than non-LDA (5.9 vs 3.6, multivariate p<0.001), and exceeded the MCID of 4 points. Conclusion Attainment of SLE-DAS remission and LDA is associated with meaningful improvement in HR-QoL and fatigue.
- Prophylatic perspectives on small animal dermatophytosis.Publication . Matos, A.; Santos, C.; Vala, Helena; Esteves, F.; Oliveira, A. L.; Cruz, R.; Mega, A. C.; Nóbrega, C.; Mesquita, J. R.
- 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.