2224 research outputs found
Sort by
Changes in Iron Metabolism Induced by Anti-Interleukin-6 Receptor Monoclonal Antibody are Associated with an Increased Risk of Infection
Get PDF(1) Background: Treatment of patients with rheumatoid arthritis (RA) with an anti-IL-6 receptor (anti-IL-6R) monoclonal antibody (tocilizumab) has been found to influence iron metabolism. The objective of the present study was to ascertain whether changes in iron metabolism induced by anti-IL-6R biologic therapy were independently associated with an increased infection risk. (2) Methods: A prospective longitudinal study of patients with RA treated with tocilizumab was conducted. RA patients treated with an antitumor necrosis factor α monoclonal antibody were also included as a control group. The primary outcome was occurrence of infection during the first 24 months of biologic therapy. (3) Results: A total of 15 patients were included, with a mean age of 51.0 ± 4,1 and 73.3% (n = 11) female. A multivariate survival regression model, adjusted for confounding factors, was fitted for each of the iron metabolism variables. Hazard ratios for being above the median of each parameter was considered. Transferrin saturation above the median value (>32.1%) was associated with a higher infection risk (HR 4.3; 95%CI 1.0-19.69; p = 0.05). Similarly, although non-significantly, higher serum iron was strongly associated with infection occurrence. (4) Conclusions: This study identified a probable association between infection risk and higher serum iron and transferrin saturation in patients with RA on anti-IL-6R biologic therapy. We suggest that both these parameters should be considered relevant contributing factors for infection occurrence in patients on anti-IL-6R therapy.info:eu-repo/semantics/publishedVersio
Translation and cross-cultural adaptation of the Arizona Sexual Scale (ASEX) into Portuguese.
Get PDFINTRODUCTION:
Sexual dysfunction is common in individuals with psychiatric disorders and under psychotropic medication such as antidepressants and antipsychotics. Several scales have been developed to assess sexual function in these patients. The Arizona Sexual Scale (ASEX) is a five-item rating scale that quantifies sex drive, arousal, vaginal lubrication/penile erection, ability to reach orgasm, and satisfaction from orgasm. We describe the translation and cross-cultural adaptation of the ASEX into the Portuguese language, with the goal of contributing to the assessment of sexual function in Portuguese-speaking psychiatric patients under treatment with psychotropic drugs.
METHODS:
The translation and cross-cultural adaptation process thoroughly followed the steps recommended by the Task Force of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), namely: preparation, forward translation, reconciliation, back-translation, back-translation review, harmonization, cognitive debriefing, review of cognitive debriefing, finalization, proofreading, and final version.
RESULTS:
The process was successfully completed and no major differences were found between the translation, reconciliation and back-translation phases, with only small adjustments being made.
CONCLUSION:
The translation of the ASEX was completed successfully, following international reference guidelines. The use of these guidelines is a guarantee of a Portuguese version that is qualitatively and semantically equivalent to the original scale. This availability of this new scale version will enable studies evaluating the sexual function of Portuguese-speaking psychiatric patients. Future studies may assess the validity of the scale for Portuguese-speaking populations.info:eu-repo/semantics/publishedVersio
Diretrizes da Sociedade Portuguesa de Cuidados Intensivos para profilaxia da úlcera de estresse na unidade de terapia intensiva
Get PDFCritically ill patients are at risk of developing stress ulcers in the upper digestive tract. Agents that suppress gastric acid are commonly prescribed to reduce the incidence of clinically important stress ulcer-related gastrointestinal bleeding. However, the indiscriminate use of stress ulcer prophylaxis in all patients admitted to the intensive care unit is not warranted and can have potential adverse clinical effects and cost implications. The present guidelines from the Sociedade Portuguesa de Cuidados Intensivos summarizes the current evidence and gives six clinical statements and an algorithm aiming to provide a standardized prescribing policy for the use of stress ulcer prophylaxis in the intensive care unit.info:eu-repo/semantics/publishedVersio
The role of prediagnostic data in injury epidemiology in preprofessional dancers
No full textINTRODUCTION: preprofessional dance training starts at very early ages, on a
highly demanding environment placing students at significant risk for injury.
Injury management and prevention are a matter of concern. Given the constant
interchangeability of risk factors, identifying injury patterns may prove to be
equally as important. Data looking back from the time of injury through
context-specific approaches are missing.
OBJECTIVES: To identify activity-related injury patterns based on prediagnostic
data.
METHODS: Prospective, non-randomized, observational study, over a 3 years period
on a full-time preprofessional dance school featuring both gender students aged
9-21 years old. Non-parametric statistics were used.
RESULTS: A total of 625 dance injury records from 209 students, n = 68 males and
n = 141 females, were analyzed. Season injury risk probability was identified,
proving different for each skill level (SkL). Multiple individual injuries
revealed a trend toward prevalence rates in advanced level, while index injuries
incidence becomes more noticeable in entry level students. Overall incidence
rates had no significant differences within SkL. Anatomical location was in line
with previous research, although differences were found between gender and SkL.
Most injuries occurred in classes, with jumps standing out as the main motor
action associated with injury symptoms of gradual onset mechanism.
CONCLUSION: Dance injuries happen because of dance practice. Knowing the context
of injury history from the injured dancer perspective is determinant for
management and prevention. prediagnostic data are an umbrella term encompassing
several aspects of injury background and represents fertile ground for research.
Context-specific methodological approaches are recommended.info:eu-repo/semantics/publishedVersio
Terapêutica antitrombótica adjuvante no enfarte do miocárdio com elevação do segment ST: dados portugueses transversais contemporâneos
No full textINTRODUCTION:
The standard of care for acute ST-elevation myocardial infarction (STEMI) includes the activation of a STEMI care network, the administration of adjuvant medical therapy, and reperfusion through primary percutaneous coronary intervention (PCI). While primary PCI is nowadays the first option for the treatment of patients with STEMI, antithrombotic therapy, including antiplatelet and anticoagulant agents, is the cornerstone of pharmacological treatment to optimize their clinical outcomes.
OBJECTIVE:
The aim of this study was to describe contemporaneous real-world patterns of use of antithrombotic treatments in Portugal for STEMI patients undergoing primary PCI.
METHODS:
An observational, retrospective cross-sectional study was performed for the year 2016, based on data from two national registries: the Portuguese Registry on Acute Coronary Syndromes (ProACS) and the Portuguese Registry on Interventional Cardiology (PRIC). Data on oral antiplatelet and procedural intravenous antithrombotic drugs were retrieved.
RESULTS:
In 2016, the ProACS enrolled 534 STEMI patients treated with primary PCI, while the PRIC registry reported data on 2625 STEMI patients. Of these, 99.6% were treated with aspirin and 75.6% with dual antiplatelet therapy (mostly clopidogrel). GP IIb/IIIa inhibitors (mostly abciximab) were used in 11.6% of cases. Heparins were used in 80% of cases (78% unfractionated heparin [UFH] and 2% low molecular weight heparin). None of the patients included in the registry were treated with cangrelor, prasugrel or bivalirudin. Missing data are one of the main limitations of the registries.
CONCLUSIONS:
In 2016, according to data from these national registries, almost all patients with STEMI were treated with aspirin and 76% with dual antiplatelet agents, mostly clopidogrel. GP IIb/IIIa inhibitors were used in few patients, and UFH was the most prevalent parenteral anticoagulant drug.info:eu-repo/semantics/publishedVersio
Perceptions, Attitudes and Practices Towards Scabies in Communities on the Bijagós Islands, Guinea-Bissau
No full textBackground: Scabies is highly endemic among impoverished populations and has been recently included in the WHO's list of neglected tropical diseases (NTDs). Community support and behavioural changes are essential for the success of control interventions. This study aimed to explore beliefs, prevention attitudes and healthcare-seeking behaviours towards scabies in the Bijagós Archipelago of Guinea-Bissau.
Methods: Data were collected through two methods. Community key informants (community members, community health workers, healthcare workers and traditional healers) were interviewed using snowball sampling. A questionnaire covering perceptions, attitudes and practices was administered to community members using random cluster sampling. Thematic analysis of qualitative data was applied to identify themes. Descriptive statistics were used for quantitative data analysis.
Results: There was a satisfactory awareness about scabies, but perceptions about disease causation and transmission were imprecise. Misconceptions about personal hygiene as the primary measure for scabies prevention were recurrent. Some participants recognised the importance of early treatment to interrupt transmission. Treatment of close contacts was not considered important. Costs were the main determining factor for treatment choice between traditional healer and the local health centre. Late presentation and delayed treatment were common and associated with poverty and stigmatisation. Scabies impaired quality of life by affecting social interactions, health, fitness to work and school attendance.
Conclusions: There is a need to improve education, recognition, management and affordable access to treatment. Community education, healthcare workers' training and skin NTD integrated control programmes should address the challenges highlighted in this study.info:eu-repo/semantics/publishedVersio