Hospital de Santa Maria
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Promoting interventions of mental health literacy of teenagers: A systematic review
No full textCONTEXTO: O conceito de literacia em saúde mental foi definido como o conhecimento e as crenças sobre distúrbios mentais que ajudam no seu reconhecimento, gestão ou prevenção. Quer internacionalmente, quer nacionalmente os estudos evidenciam reduzida literacia em saúde mental dos adolescentes e a necessidade de serem desenvolvidas intervenções em contexto escolar para aumentar o seu nível de literacia em saúde mental.
OBJETIVO: Foi realizada uma revisão sistemática da literatura com o objetivo de identificar a evidência científica atual e disponível sobre as intervenções promotoras da literacia em saúde mental dos adolescentes.
METODOLOGIA: Foi formulada a questão de investigação segundo a mnemónica PICO: Que intervenções (I) promovem a literacia em saúde mental (O) dos adolescentes (P)? e definidos os critérios de selecção dos estudos. Seguidamente foram selecionadas as palavras-chave que permitiram realizar a pesquisa. Foram efetuadas as pesquisas em bases de dados electrónicas durante os meses de Abril e Maio de 2013, para resultados de 2008 a 2013.
RESULTADOS: Resultaram 15 artigos em texto completo, dos quais 12 artigos foram excluídos. Foram incluídos 3 artigos submetidos posteriormente à avaliação da sua qualidade metodológica.
CONCLUSÕES: Os estudos indicam a necessidade de serem desenvolvidas, validadas e avaliadas intervenções que promovam a literacia em saúde mental dos adolescentes. No entanto, a complexidade das intervenções de promoção da literacia em saúde mental dos adolescentes exige que essas sejam investigadas através de um processo de desenvolvimento, viabilidade/pilotagem, avaliação e implementação
Técnicas Transobturadoras na Incontinência Urinária de Esforço Feminina
Get PDFStress urinary incontinence affects about 20-40% of women. Treatment with transobturator mid-urethral slings is consensually accepted nowadays. The goal of this study was to evaluate the success rate and most frequent complications of surgical treatment with transobturator mid-urethral slings in stress urinary incontinence.info:eu-repo/semantics/publishedVersio
Cardiovascular risk analysis by means of pulse morphology and clustering methodologies
No full textThe purpose of this study was the development of a clustering methodology to deal with arterial pressure waveform (APW) parameters to be used in the cardiovascular risk assessment. One hundred sixteen subjects were monitored and divided into two groups. The first one (23 hypertensive subjects) was analyzed using APW and biochemical parameters, while the remaining 93 healthy subjects were only evaluated through APW parameters. The expectation maximization (EM) and k-means algorithms were used in the cluster analysis, and the risk scores (the Framingham Risk Score (FRS), the Systematic COronary Risk Evaluation (SCORE) project, the Assessing cardiovascular risk using Scottish Intercollegiate Guidelines Network (ASSIGN) and the PROspective Cardiovascular Münster (PROCAM)), commonly used in clinical practice were selected to the cluster risk validation. The result from the clustering risk analysis showed a very significant correlation with ASSIGN (r=0.582, p<0.01) and a significant correlation with FRS (r=0.458, p<0.05). The results from the comparison of both groups also allowed to identify the cluster with higher cardiovascular risk in the healthy group. These results give new insights to explore this methodology in future scoring trials.info:eu-repo/semantics/publishedVersio
Can cardiac computed tomography predict cardiovascular events in asymptomatic type-2 diabetics?: results of a long term follow-up
No full textBACKGROUND:
Doubts remain about atherosclerotic disease and risk stratification of asymptomatic type-2 diabetic patients (T2DP). This study aims to evaluate the usefulness of calcium score (CS) and coronary computed tomography (CT) angiography (CTA) to predict fatal and non fatal cardiovascular events (CVEV) in T2DP.
METHODS:
Eighty-five consecutive T2DP undergoing CT (Phillips Brilliance, 16-slice) with CS and CTA were prospectively enrolled in a transversal case-control study. Patients were followed for 48 months (range 18 - 68) to assess CVEV: cardiovascular death, acute coronary syndrome, revascularisation and stroke. Potential predictors of CVEV were identified. Predictive models based on clinical features, CTA and CS were created and compared.
RESULTS:
Performing CT impacted T2DP treatment. Cardiovascular risk was lowered during follow-up but metabolic control remained suboptimal. CVEV occurred in 11.8% T2DP (3.1%/year). CS ≥86.6 was predictor of CVEV over time, with a high negative predictive value, an 80% sensitivity and 74.7% specificity. Although its prognostic value was not independent of the presence/absence of obstructive CAD, adding CS and CTA data to clinical parameters improved the prediction of CVEV: the combined model had the highest AUC (0.888, 95%CI 0.789-0.987, p < 0.001) for the prediction of the study endpoints.
CONCLUSIONS:
CS showed great value in T2DP risk stratification and its prognostic value was further enhanced by CTA data. Information provided by CT may help predict CVEV in T2DP and potentially improve their outcome
Virtual touch imaging and quantification: is it possible to distinguish “unaffected” skin in scleroderma patients from healthy skin?
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