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During the COVID-19 pandemic, many patients in intensive care units (ICUs) were affected by invasive fungal infections, including aspergillosis, contributing to a high mortality rate. Diagnosing proven COVID-19-associated pulmonary aspergillosis (CAPA) requires clinical and radiological evaluations, along with laboratory testing of bronchoalveolar lavage samples or lung biopsies. However, these procedures and equipment are often inaccessible in developing countries or regions with limited resources, including Brazil. Consequently, alternative diagnostic methods, such as measuring Aspergillus galactomannan (GM) in tracheal aspirate (TA), have been explored for CAPA diagnosis. Nonetheless, research on the efficacy of TA-based diagnostic tests is limited. This study aimed to assess the performance of the IMMY® Sona Aspergillus lateral flow assay (LFA) for GM detection in TA samples from 60 ICU patients with suspected CAPA at two tertiary hospitals in Campo Grande, Brazil. The ELISA method (Platelia Aspergillus AG, Bio-Rad®) was used to detect Aspergillus GM in TA samples, serving as the microbiological criterion and reference test. Fifteen patients (12.4%) were identified as having possible CAPA. The overall accuracy of LFA was 94%, and the tests demonstrated an agreement of 93.1% (Cohen's kappa of 0.83). Based on our findings, the LFA for Aspergillus GM detection in TA samples exhibited excellent performance, proving to be a valuable diagnostic tool for potential CAPA. In a systematic review, two studies were included, and the meta-analysis revealed pooled estimates provided a sensitivity of 86% (95% CI, 80%-91%) and specificity of 93% (95% CI, 86%-97%). The diagnostic odds ratio (DOR) for identification of Aspergillus using LFA was 103.38 (95% CI, 38.03-281.03). Despite its lower sensitivity compared to our study, the LFA appears to be a promising diagnostic option for CAPA, particularly in suspected cases that have not received antifungal therapy. This enables timely antifungal treatment and could reduce mortality rates in regions where bronchoscopy is unavailable or limited.
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Aspergillus , COVID-19 , Galactosa , Mananos , Sensibilidad y Especificidad , Tráquea , Humanos , Galactosa/análogos & derivados , Mananos/análisis , Brasil , COVID-19/complicaciones , COVID-19/diagnóstico , Aspergillus/aislamiento & purificación , Tráquea/microbiología , Persona de Mediana Edad , Estudios Transversales , Masculino , Femenino , Aspergilosis Pulmonar/diagnóstico , Anciano , Adulto , SARS-CoV-2/aislamiento & purificación , Unidades de Cuidados IntensivosRESUMEN
Tumor-associated myeloid-derived cells (MDCs) significantly impact cancer prognosis and treatment responses due to their remarkable plasticity and tumorigenic behaviors. Here, we integrate single-cell RNA-sequencing data from different cancer types, identifying 29 MDC subpopulations within the tumor microenvironment. Our analysis reveals abnormally expanded MDC subpopulations across various tumors and distinguishes cell states that have often been grouped together, such as TREM2+ and FOLR2+ subpopulations. Using deconvolution approaches, we identify five subpopulations as independent prognostic markers, including states co-expressing TREM2 and PD-1, and FOLR2 and PDL-2. Additionally, TREM2 alone does not reliably predict cancer prognosis, as other TREM2+ macrophages show varied associations with prognosis depending on local cues. Validation in independent cohorts confirms that FOLR2-expressing macrophages correlate with poor clinical outcomes in ovarian and triple-negative breast cancers. This comprehensive MDC atlas offers valuable insights and a foundation for futher analyses, advancing strategies for treating solid cancers.
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Glicoproteínas de Membrana , Células Mieloides , Neoplasias , Receptores Inmunológicos , Análisis de la Célula Individual , Microambiente Tumoral , Humanos , Análisis de la Célula Individual/métodos , Microambiente Tumoral/genética , Microambiente Tumoral/inmunología , Células Mieloides/metabolismo , Células Mieloides/patología , Receptores Inmunológicos/metabolismo , Receptores Inmunológicos/genética , Glicoproteínas de Membrana/metabolismo , Glicoproteínas de Membrana/genética , Pronóstico , Neoplasias/genética , Neoplasias/patología , Neoplasias/metabolismo , Femenino , Receptor de Muerte Celular Programada 1/metabolismo , Receptor de Muerte Celular Programada 1/genética , Biomarcadores de Tumor/metabolismo , Biomarcadores de Tumor/genética , Neoplasias de la Mama Triple Negativas/genética , Neoplasias de la Mama Triple Negativas/patología , Neoplasias de la Mama Triple Negativas/metabolismo , Neoplasias Ováricas/patología , Neoplasias Ováricas/genética , Neoplasias Ováricas/metabolismo , Antígeno B7-H1/metabolismo , Antígeno B7-H1/genéticaRESUMEN
Commercial environments and food acquisition methods significantly shape dietary practices and impact health. This study assesses dietary choices among Portuguese university students regarding vending machines, canteens, and lunches from home. It also evaluates their use of the university canteen and their tendency to bring lunch from home. This pilot cross-sectional study used a self-administered electronic questionnaire, made available in early 2023. Participants were recruited through snowball sampling. The study included 137 students from Portuguese higher education institutions, mainly women (74.5%), pursuing degrees or integrated Master's degrees (83.2%), primarily in health-related fields (55.5%). The median age was 21 years (20 to 23.5 years). About 70.0% regularly consumed food from vending machines, while approximately 60.0% brought lunch from home, avoiding the canteen. Factors such as convenience (48.5%), price (47.5%), product availability (40.6%), and taste (39.6%) mainly influenced vending machine choices. Monthly, chocolates, water, coffee, cookies, treats, and soft drinks were the most commonly acquired items, with coffee being the most frequent daily purchase. These findings provide insights for creating policies and initiatives to promote healthier and more accessible food options for students and strategies to encourage positive eating behaviors.
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Conducta de Elección , Distribuidores Automáticos de Alimentos , Preferencias Alimentarias , Servicios de Alimentación , Almuerzo , Estudiantes , Humanos , Proyectos Piloto , Femenino , Universidades , Masculino , Adulto Joven , Estudios Transversales , Distribuidores Automáticos de Alimentos/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , Servicios de Alimentación/estadística & datos numéricos , Portugal , Encuestas y Cuestionarios , Adulto , Dieta/estadística & datos numéricos , Conducta AlimentariaRESUMEN
Celiac disease (CD) is an autoimmune chronic enteropathy provoked by gluten ingestion in genetically predisposed individuals. Considering it´s only safe treatment is a lifelong gluten-free diet, the burden of living with the disease becomes evident, as well as the need to assess CD health-related quality of life (HRQOL). This review aims to identify and analyze the instruments used to evaluate the HRQOL of adults with CD. This integrative review using a systematic approach was designed to achieve high scientific standards. Accordingly, the search strategy was developed and executed as recommended by the guideline of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Detailed individual searches were developed to Pubmed, Science Direct, Scopus, Web of Science, and Google Scholar. After careful analysis of the papers, 43 studies were included, in which seven instruments were identified: Celiac Disease Questionnaire (CDQ) (n=21), Celiac Disease Specific Quality of Life Instrument (CD-QOL) (n=17), Celiac Disease Assessment Questionnaire (CDAQ) (n=4), CeliacQ-7 (n=1), CeliacQ-27 (n=1), Black and Orfila´s self-developed instrument (n=1) and the Coeliac Disease Quality of Life Questionnaire (CDQL) (n=1). The CDQ and CD-QOL were the two most applied instruments. Since the first focuses on the physical and mental symptoms related to the disease and the second focuses on the emotional repercussions of adhering to the GFD treatment for life (dysphoria), the CDQ application is an interesting option for countries that struggle with public policies for CD patients and patients with active CD. The CD-QOL could be used for countries with strict regulations for CD and gluten-free products and populations in remission. When comparing results among different populations, it is preferable to utilize culturally validated instruments, which have been applied across multiple countries, providing greater comparability between study findings.
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Enfermedad Celíaca , Calidad de Vida , Enfermedad Celíaca/psicología , Enfermedad Celíaca/dietoterapia , Humanos , Encuestas y Cuestionarios , Dieta Sin GlutenRESUMEN
Celiac disease (CD) is an autoimmune disease triggered by the ingestion of gluten in genetically predisposed individuals, affecting 1.4% of the world population. CD induces an inflammatory reaction that compromises small intestine villi, leading to nutrient malabsorption, and gastro and extraintestinal manifestations. Although other treatment approaches are being studied, adherence to a gluten-free diet (GFD) is the only effective intervention to date. Despite this, about 50% of patients experience persistent inflammation, often associated with unintentional gluten ingestion through contaminated food. There are regulations for labeling gluten-free foods which specify a limit of 20 mg/kg (20 ppm). The risks of gluten cross-contamination above that level are present throughout the whole food production chain, emphasizing the need for caution. This review explores studies that tested different procedures regarding the shared production of gluten-containing and gluten-free food, including the use of shared equipment and utensils. A literature review covering PubMed, Scielo, Web of Science, VHL and Scopus identified five relevant studies. The results indicate that shared environments and equipment may not significantly increase gluten cross-contamination if appropriate protocols are followed. Simultaneous cooking of gluten-containing and gluten-free pizzas in shared ovens has demonstrated a low risk of contamination. In general, shared kitchen utensils and equipment (spoon, ladle, colander, knife, fryer, toaster) in controlled experiments did not lead to significant contamination of samples. On the other hand, cooking gluten-free and gluten-containing pasta in shared water resulted in gluten levels above the established limit of 20 ppm. However, rinsing the pasta under running water for a few seconds was enough to reduce the gluten content of the samples to less than 20 ppm.
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Enfermedad Celíaca , Dieta Sin Gluten , Contaminación de Alimentos , Manipulación de Alimentos , Glútenes , Humanos , Glútenes/efectos adversos , Enfermedad Celíaca/dietoterapia , Enfermedad Celíaca/etiología , Manipulación de Alimentos/métodos , Contaminación de Alimentos/análisis , Culinaria/métodosRESUMEN
This cross-sectional and analytical study aimed to characterize a sample of hypertensive older adults attending a Mobile Health Unit (MHU) in a rural area of central Portugal according to their lifestyle and to analyze the impact of lifestyles on treatment adherence. The sample comprised 235 Portuguese hypertense patients, mainly females (63.8%) with a mean age of 75 years (±8.14 years) and low level of education. The data collection was carried out through a questionnaire consisting of sociodemographic questions, dietary variables, an Alcohol Dependence Questionnaire, an International Physical Activity Questionnaire (Short Version), a Nutrition Health Determination Questionnaire, a Self-Care with Hypertension Scale, and an Adherence to Treatments Measurement Scale. Only 34.5% of the hypertensive patients have controlled blood pressure values (28.2% men and 38% women). However, more than half (56.2%) of the hypertensive patients are classified as adherent to therapeutic measures. The hypertensive individuals, who present higher levels of adherence to the treatment, do not present alcohol dependence, are frequent consumers of aromatic herbs, sporadically consume salt, present good nutritional health, and practice moderate physical activity. The predictor variables for treatment adherence are the self-care dimensions general dietary (p = 0.001), specific dietary (p = 0.034), physical activity (p = 0.031), and antihypertensive medication intake (p < 0.001). Hypertensive patients with healthier lifestyles present better levels of treatment adherence. Therefore, promoting physical activity and healthy dietary practices is necessary to improve treatment adherence and increase antihypertensive treatment's effectiveness.
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Ejercicio Físico , Hipertensión , Estilo de Vida , Unidades Móviles de Salud , Población Rural , Humanos , Femenino , Masculino , Anciano , Hipertensión/tratamiento farmacológico , Hipertensión/epidemiología , Portugal , Estudios Transversales , Anciano de 80 o más Años , Encuestas y Cuestionarios , Antihipertensivos/uso terapéutico , Cumplimiento y Adherencia al Tratamiento/estadística & datos numéricos , DietaRESUMEN
Objective: This study aimed to compare the 36-Item Short Form Survey Instrument version 2 (SF-36-v2) (generic) and Celiac Disease Questionnaire (CDQ) (specific) questionnaires used to evaluate the quality of life (QoL) in celiac Portuguese adult individuals. Methods: This cross-sectional study used non-probabilistic sampling based on Portuguese celiac patients who accessed the online survey in 2022. The online data collection used a self-reported instrument composed of three parts: (i) socioeconomic, health, and gluten-free diet (GFD) adherence questions; (ii) SF-36 v2 - Portuguese version (generic questionnaire) and (iii) Celiac Disease Questionnaire (CDQ) (specific questionnaire). Results: A total of 234 individuals who accessed the survey completed the questionnaire. Seven of the eight SF-36 domains positively correlated to the specific questionnaire CDQ. The "General Health" domain (domain 4) showed a negative correlation with the CDQ. Differences in content between the two instruments might be able to explain this finding since the CDQ explores issues regarding the specificities of celiac disease (CD) and the lifelong GFD burden. About half of the sample from this study displayed poor diet adherence, it is possible that the SF-36 could not reflect the impact of CD treatment - the complete elimination of gluten from the diet - on patients' health. Therefore, this issue should be carefully evaluated in future research. Conclusion: Specific validated questionnaires for CD individuals, such as the CDQ, contemplate social, economic, and clinical variables that permeate the patient's life context. Therefore, these instruments may be more suitable for evaluating QoL in this public. However, using a general questionnaire such as the SF-36 would be indicated for comparing QOL between celiac patients and the general population or even between CD and other disease individuals. In this case, we recommend assessing GFD compliance for control parallelly.
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Enfermedad Celíaca , Calidad de Vida , Adulto , Humanos , Portugal , Estudios Transversales , Encuestas y CuestionariosRESUMEN
Licuri (Syagrus coronata) is an oilseed fruit common in the Brazilian caatinga and cerrado biomes. This fruit has high socioeconomic importance in the regions where it grows, being incorporated into exported animal feed and also into gastronomic preparations. Cereal bars are ready-to-eat highly consumed products with increased demand, commonly made with cereals and oilseeds such as licuri. In this sense, the incorporation of licuri in cereal bars may increase its socioeconomic value and expand its potential use. Thus, the objective of the study was to analyze acceptance and describe the sensory characteristics of cereal bars incorporated with licuri nuts. This study was conducted in four stages: (1) development of samples; (2) chemical composition analysis; (3) sensory analysis; and (4) statistical analysis. Cereal bars with licuri presented proportionally lower carbohydrate and protein content as the incorporation of licuri nut increased. However, the dietary fiber content increased. Further, 122 untrained panelists participated in the analysis. The results showed that samples with all proportions of incorporation of licuri nuts were acceptable. Furthermore, the sensory descriptors related to the presence of licuri were positively associated with product acceptance. In this way, this study demonstrates yet another possibility for use of the fruit, increasing its socioeconomic potential.
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BACKGROUND: Approximately 3/4 of ovarian cancers are diagnosed in advanced stages, with the high-grade epithelial ovarian carcinoma (EOC) accounting for 90% of the cases. EOC present high genomic instability and somatic loss-of-function variants in genes associated with homologous recombination mutational repair pathway (HR), such as BRCA1 and BRCA2, and in TP53. The identification of germline variants in HR genes in EOC is relevant for treatment of platinum resistant tumors and relapsed tumors with therapies based in synthetic lethality such as PARP inhibitors. Patients with somatic variants in HR genes may also benefit from these therapies. In this work was analyzed the frequency of somatic variants in BRCA1, BRCA2, and TP53 in an EOC cohort of Brazilian patients, estimating the proportion of variants in tumoral tissue and their association with progression-free survival and overall survival. METHODS: The study was conducted with paired blood/tumor samples from 56 patients. Germline and tumoral sequences of BRCA1, BRCA2, and TP53 were obtained by massive parallel sequencing. The HaplotypeCaller method was used for calling germline variants, and somatic variants were called with Mutect2. RESULTS: A total of 26 germline variants were found, and seven patients presented germline pathogenic or likely pathogenic variants in BRCA1 or BRCA2. The analysis of tumoral tissue identified 52 somatic variants in 41 patients, being 43 somatic variants affecting or likely affecting protein functionality. Survival analyses showed that tumor staging was associated with overall survival (OS), while the presence of somatic mutation in TP53 was not associated with OS or progression-free survival. CONCLUSION: Frequency of pathogenic or likely pathogenic germline variants in BRCA1 and BRCA2 (12.5%) was lower in comparison with other studies. TP53 was the most altered gene in tumors, with 62.5% presenting likely non-functional or non-functional somatic variants, while eight 14.2% presented likely non-functional or non-functional somatic variants in BRCA1 or BRCA2.
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Neoplasias Ováricas , Humanos , Femenino , Carcinoma Epitelial de Ovario/genética , Brasil/epidemiología , Neoplasias Ováricas/genética , Reparación del ADN , Células Germinativas , Proteína p53 Supresora de Tumor/genética , Proteína BRCA1/genética , Proteína BRCA2/genéticaRESUMEN
This study investigated the presence of front-of-package labeling on food products in major retailers in Brazil after its implementation in 2022. Carried out from May to October 2023, we analyzed 2145 products of brands present in five Brazilian states. A total of 541 products presented front-of-package warnings. The categories varied in their adherence to front-of-package labeling, highlighting a prevalence of combined warnings, such as high in added sugar and high in saturated fat on sweet biscuits and chocolates. Sausages showed a high prevalence of high in sodium and high in saturated fat warnings. Beverages stood out as high in added sugar, while fats, dairy products, frozen preparations, seasonings, and sauces presented diversity in the warnings. Other products, such as panettone, showed a high presence of alerts. The study demonstrated the widespread presence of front-of-package labeling on ultra-processed products highly consumed by the Brazilian population. Considering the alarming presence of these foods in the Brazilian diet, it is concluded that front-of-package nutrition labeling is crucial to inform and raise awareness among consumers, allowing healthier choices and potentially contributing to a reduction in chronic diseases and the costs associated with treatment in the health system.
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Bebidas , Etiquetado de Alimentos , Brasil , Azúcares , Productos Lácteos , Valor Nutritivo , Comportamiento del ConsumidorRESUMEN
ABSTRACT Objective: To determine the prevalence of ocular alterations in patients diagnosed with dengue, admitted to a reference center for infectious and parasitic diseases in Manaus (AM), Brazil. Methods: This was an observational, analytical, and prospective case series study with 33 patients admitted to the hospital with positive clinical pathology tests during a 90-day period of a dengue epidemic in 2011. The investigations included measurement of visual acuity, macular assessment with Amsler grid test, fundus biomicroscopy, retinography and optical coherence tomography. Results: The average age of the patients was 35.48 years (minimum age 17 years and maximum 69 years). The main symptoms reported were blurred vision, followed by retro-ocular pain, photopsia, halos, foreign bodies, scotoma, double vision, and floaters. Visual acuity ranged from 20/20 to 20/40 (median 20/30). Macular assessment with Amsler Grid Test was unsatisfactory in three patients. The most common retinal findings were perimacular edema, macular edema, retinal hemorrhage, vasculitis, and changes in the retinal pigment epithelium. Optical coherence tomography showed retinal edema in 16 patients (51.51%). Conclusions: In all cases, the disease was self-limiting and resolved spontaneously without treatment. Therefore, this study confirms that ocular manifestations in dengue fever are varied and frequent.
RESUMO Objetivo: Determinar a prevalência de alterações oculares em pacientes com diagnóstico de dengue, internados em um centro de referência para doenças infecciosas e parasitárias em Manaus (AM), Brasil. Métodos: Estudo observacional, analítico e prospectivo de série de casos de 33 pacientes admitidos no hospital com exames de patologia clínica positivos durante um período de 90 dias de uma epidemia de dengue em 2011. As investigações incluíram medida da acuidade visual, avaliação macular com tela de Amsler, biomicroscopia de fundo de olho, retinografia e tomografia de coerência ótica. Resultados: A idade média dos pacientes foi de 35,48 anos (idade mínima de 17 anos e máxima de 69 anos). Os principais sintomas relatados foram visão turva, seguida de dor retro-ocular, fotopsia, halos, corpos estranhos, escotoma, visão dupla e moscas volantes. A acuidade visual variou entre 20/20 e 20/40 (mediana 20/30). A avaliação macular com a tela de Amsler foi insatisfatória em três doentes. Os achados retinianos mais comuns foram edema perimacular, edema macular, hemorragia retiniana, vasculite e alterações no epitélio pigmentar da retina. A tomografia de coerência óptica mostrou edema da retina em 16 doentes (51,51%). Conclusões: Em todos os casos, a doença foi autolimitada e resolveu-se espontaneamente sem tratamento. Este estudo confirma, portanto, que as manifestações oculares da dengue são variadas e frequentes.
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Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of gluten in genetically predisposed individuals. In this sense, a gluten-free diet is the only safe treatment available. Due to the restrictions resulting from this eating pattern, this treatment may impair the relationship of the people with CD with food, increasing the risk of a disordered eating attitude, which is associated with eating disorders. The EAT-26 is a validated instrument already applied worldwide in different populations, and higher scores are suggestive of eating attitudes prone to evolve into eating disorders. Studies carried out in other countries have already shown that people with CD are prone to developing eating disorders; however, no study has been carried out with this theme in the population with CD in Brazil. We carried out a nationwide cross-sectional study in three steps: (i) study design and instrument; (ii) recruitment of participants and ethics; (iii) statistical analysis. A total of 385 participants were included in our sample, 96.36% of them being women. The internal consistency of the applied self-administered Brazilian version of the EAT-26 online questionnaire presented a satisfactory Cronbach's alpha of 0.812, and in total, 36.1% of the respondents were classified with a disordered eating attitude. No differences were found among the scores of participants when divided by categories regarding gender, average monthly income, age, and educational level. However, scores classified as a disordered eating attitude were found in respondents with a body mass index classified as overweight and obese. Our study highlights that disordered eating attitudes are present in overweight and obese women with celiac disease; thus, public health politics are needed to prevent and treat these attitudes.
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Enfermedad Celíaca , Trastornos de Alimentación y de la Ingestión de Alimentos , Humanos , Femenino , Masculino , Enfermedad Celíaca/epidemiología , Brasil/epidemiología , Sobrepeso , Estudios Transversales , Encuestas y Cuestionarios , ObesidadRESUMEN
The aim of this study is to assess Portuguese celiac patients' quality of life (QoL) perception. A cross-sectional study was performed with a non-probability convenience sample of Portuguese celiac patients using an online self-administered celiac disease quality of life questionnaire (CDQ), previously validated for the Portuguese population. The final sample comprised 234 celiac patients, which included the following: primarily women (69.2%); aged between 18 and 49 years old (56.4%); with a partner (60.6%); with a high educational level (58.9%-graduated or post-graduated); following a gluten-free diet (GFD) (55.1%); and not using antidepressants (93.1%). The Portuguese CDQ presented good reliability and responsiveness in this sample of Portuguese celiac patients. In general, the CDQ in Portugal was affected by age at diagnosis (p = 0.017), educational level (p = 0.005), and compliance with GFD (p = 0.034). The emotion domain was affected only by using antidepressants (p = 0.036). The social domain was affected by gender (females had lower rates, p = 0.016), age at diagnosis (p = 0.009), educational level (p = 0.000), and compliance with a GFD (p = 0.002). The worries domain did not differ according to socioeconomic data. The symptoms domain was affected by compliance with GFD (p = 0.000), age at diagnosis (p = 0.000), and educational level (p = 0.014). Data on celiac QoL is essential to support the formulation and implementation of strategies to minimize the issues suffered by celiac patients, lowering their physical, emotional, and social burden. Additionally, data on Portuguese celiac disease patients using the CDQ will allow future comparative research among celiac populations from different countries.
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Enfermedad Celíaca , Calidad de Vida , Humanos , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Estudios Transversales , Portugal , Reproducibilidad de los Resultados , PercepciónRESUMEN
Low mental health literacy levels have a profound negative effect on healthcare outcomes, usage of healthcare services and healthcare expenditure. To date, there is little research and a lack of instruments available to address and assess positive mental health literacy levels in community-dwelling adults. Thus, this study sought to develop an instrument to assess positive mental health literacy in adults and to evaluate its psychometric properties. A scale developed in European Portuguese and composed of 32 items was designed to assess positive mental health literacy among community-dwelling adults and was validated using exploratory factor analysis. Five latent factors were identified (decision making, prosocial attitudes, perception of resources, community involvement, and problem solving), whose hypothesised structure was confirmed by confirmatory factor analysis using structural equation modelling. Evidence showed that the scale's factor structure is reliable and valid and adequately represents the theorised constructs. Thus, this may be a useful assessment tool for clinical practice since it will allow a more rigorous assessment of positive mental health literacy and better mental health promotion interventions in the population.
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Alfabetización en Salud , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Salud Mental , PsicometríaRESUMEN
A significant part of the worldwide population is affected by some mental disorder. Previous research conducted with the general population has revealed poor knowledge when it comes to mental health. Therefore, it is imperative to assess mental health literacy using robust assessment tools. Thus, this study aimed to translate, adapt and assess the psychometric properties of the Mental Health Knowledge Questionnaire in a sample of higher education students in Portugal. This study used a sample consisting of 2887 participants. Internal consistency for the psychometric study was estimated using Cronbach's alpha coefficient. Construct validity was tested using exploratory and confirmatory factor analysis, convergent validity, and discriminant validity. After data analysis, the final Portuguese version of the Mental Health Knowledge Questionnaire was composed of 14 items. The goodness-of-fit indices were adequate, confirming the quality of the model's fit to the empirical data (χ²/df = 2.459, GFI = 0.983, CFI = 0.969, RMSEA = 0.032, RMR = 0.023, SRMR = 0.032). This assessment tool is valid and reliable to assess higher education students' mental health literacy in Portugal. Analyses to confirm the scale's external validity, measurement equivalence and replicability are still required.
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Salud Mental , Estudiantes , Humanos , Portugal , Psicometría , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
Resumo Enquadramento: A motivação para a prática de atividade física condiciona a adesão à atividade a realizar e o envolvimento a longo prazo. Objetivos: Analisar a motivação dos estudantes de enfermagem para a prática de atividade física. Identificar as variáveis sociodemográficas e académicas que interferem na prática de atividade física. Metodologia: Estudo descritivo, analítico, com 372 estudantes de enfermagem. Aplicou-se um questionário de caracterização sociodemográfica, o Questionário de Motivação para o Exercício e o Questionário Internacional de Avaliação da Atividade Física. Resultados: Motivos relacionados com a condição física, de saúde e relacionados com o corpo foram os mais indicados pelos estudantes para a prática de atividade física. Os estudantes do sexo masculino (OM = 227,67) e dos 2º e 3º anos apresentam maior índice de atividade física. Quanto mais idade, menor a atividade física. Conclusão: Motivos psicológicos estabelecem relação direta e os motivos de saúde relação inversa com a prática de atividade física, sugerindo que maior motivação psicológica e melhores níveis de saúde conduzem a uma maior prática de atividade física.
Abstract Background: Long-term involvement and adherence to physical activity are conditioned by motivation. Objectives: To analyze nursing students' motivation to engage in physical activity and to identify the sociodemographic and academic variables that interfere with the practice of physical activity. Methodology: This is a descriptive and analytical study involving 372 nursing students. A sociodemographic characterization questionnaire, the Exercise Motivations Inventory (EMI-2), and the International Physical Activity Questionnaire (IPAQ) were administered. Results: The students' most frequent motives for physical activity were physical fitness, health, and body-related motives. Male students (MR = 227.67) and 2nd and 3rd-year students had the highest physical activity levels. This study also observed that the older the students, the lower the physical activity levels. Conclusion: The psychological motives are directly related to physical activity, whereas health motives are inversely related to physical activity, which suggests that higher psychological motivation and better levels of health lead to higher levels of physical activity.
Resumen Marco contextual: La motivación para la práctica de la actividad física condiciona la adherencia a la actividad que se va a realizar y la implicación a largo plazo. Objetivos: Analizar la motivación de los estudiantes de enfermería para realizar actividad física. Identificar las variables sociodemográficas y académicas que interfieren en la práctica de actividad física. Metodología: Estudio descriptivo y analítico, con 372 estudiantes de enfermería. Se aplicó un cuestionario de caracterización sociodemográfica, el Cuestionario de Motivación para el Ejercicio y el Cuestionario Internacional de Evaluación de la Actividad Física. Resultados: Los motivos relacionados con la condición física, la salud y el cuerpo fueron los más indicados por los estudiantes para practicar actividad física. Los estudiantes del sexo masculino (OM = 227,67) y los de 2.º y 3.er año presentan mayor índice de actividad física. Cuanto mayor es la edad, menor es su actividad física. Conclusión: Los motivos psicológicos establecen una relación directa y los motivos de salud una relación inversa con la práctica de actividad física, lo que sugiere que una mayor motivación psicológica y mejores niveles de salud conducen a una mayor práctica de actividad física.
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Peripheral facial paralysis (PFP) has been shown to be a neurological manifestation of COVID-19. The current study presents two cases of PFP after COVID-19, along with a rapid review of known cases in the literature. Both case reports were conducted following CARE guidelines. We also performed a systematic review of PFP cases temporally related to COVID-19 using PubMed, Embase, and Cochrane Library databases on August 30, 2021, using a rapid review methodology. The two patients experienced PFP 102 and 110 days after COVID-19 symptom onset. SARS-CoV-2 RNA was detected in nasal samples through reverse-transcription real-time polymerase chain reaction (RT-qPCR) testing. Anosmia was the only other neurological manifestation. PFP was treated with steroids in both cases, with complete subsequent recovery. In the rapid review, we identified 764 articles and included 43 studies. From those, 128 patients with PFP were analyzed, of whom 42.1% (54/128) were male, 39.06% (50/128) female, and in 23 cases the gender was not reported. The age range was 18 to 59 (54.68%). The median time between COVID-19 and PFP was three days (ranging from the first symptom of COVID-19 to 40 days after the acute phase of infection). Late PFP associated with COVID-19 presents mild symptoms and improves with time, with no identified predictors. Late PFP should be added to the spectrum of neurological manifestations associated with the long-term effects of SARS-CoV-2 infection as a post COVID-19 condition.
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Background: Falls are a major public health issue, given their prevalence and social impact. Older adults living in long-term care facilities (LTCF) are at greater risk of injury resulting from a fall due to multiple factors, such as nutritional, functional/cognitive impairment, postural instability, polypharmacy, and the presence of potentially inappropriate medications (PIMs). Medication management in LTCF is complex and often sub-optimal and might be crucial for falls. Pharmacist intervention is important, since they have a unique knowledge of medication. However, studies mapping the impact of pharmaceutical activities in Portuguese LTC settings are scarce. Objective: This study aims to assess the characteristics of older adult fallers living in LTFCs and examine the relationship between falling and several factors in this population. We also intend to explore the prevalence of PIMs and their relationship with the occurrence of falls. Methods: The study was conducted in two long-term care facilities for elderly people, in the central region of Portugal. We included patients aged 65 and older with no reduced mobility or physical weakness and with the ability to understand spoken and written Portuguese. The following information was assessed: sociodemographic characteristics, comorbidities, polypharmacy, fear of falling, functional, nutritional and cognitive status. PIMs were evaluated according to the Beers criteria (2019). Results: A total of 69 institutionalised older adults, 45 women and 24 men, with a mean age of 83.14 ± 8.87 years were included. The prevalence of falls was 21.74% Out of these, 46.67% (n=7) fell once, 13.33% (n=2) fell twice, and 40% (n=6) fell 3 or more times. Fallers were mainly women, had lower levels of education, were well nourished, had moderate to severe levels of dependence, and displayed moderate cognitive impairment. (AU)
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Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Accidentes por Caídas , Farmacéuticos , Estudios Transversales , Portugal , Lista de Medicamentos Potencialmente Inapropiados , PolifarmaciaRESUMEN
BACKGROUND: Data on the prevalence of chronic pulmonary aspergillosis (CPA) in patients with active or cured tuberculosis (TB) are scarce, mainly due to diagnostic difficulties. The diagnosis of CPA is based on pulmonary symptoms and chest computed tomography (CT) scans and is considered confirmed when there is microbiological or serological evidence of Aspergillus spp. OBJECTIVES: To estimate the prevalence of CPA in patients treated or undergoing treatment for PTB, seen in two referral hospitals in Mato Grosso do Sul, Brazil. PATIENTS AND METHODS: A total of 193 consecutive patients who were treated or previously treated for pulmonary tuberculosis underwent prospective evaluation: (a) clinical evaluation; (b) chest CT scan; (c) sputum examination-culture for fungi and smears for direct mycology; (d) detection of anti-Aspergillus fumigatus antibodies using an enzyme-linked immunosorbent assay Platelia® test; and (e) anti-Aspergillus spp. antibodies were assessed via a DID test. RESULTS: The global prevalence of CPA was 10.9% (95% confidence interval, 7.2%-16.1%), but it increased with the time of TB diagnosis. The variables independently associated with CPA were previous pulmonary tuberculosis over 4 years ago and haemoptysis. Cavities, pleural thickening and the presence of a fungal ball were the most frequent tomographic findings in patients with CPA. CONCLUSIONS: The high prevalence observed and its increase over time suggest the need for continuous surveillance of CPA in patients with active or previous pulmonary tuberculosis and throughout life, with clinical, tomographic and serological evaluations (ELISA) for a timely diagnosis and a better prognosis.
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Aspergilosis Pulmonar , Tuberculosis Pulmonar , Tuberculosis , Aspergillus , Brasil/epidemiología , Enfermedad Crónica , Humanos , Infección Persistente , Prevalencia , Estudios Prospectivos , Aspergilosis Pulmonar/complicaciones , Aspergilosis Pulmonar/diagnóstico , Aspergilosis Pulmonar/epidemiología , Tuberculosis/complicaciones , Tuberculosis Pulmonar/complicaciones , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/epidemiologíaRESUMEN
OBJECTIVE: To describe the prevalence of metabolic syndrome and other metabolic indicators in patients with endometrial cancer and its association with tumor grade. METHODS: This is a cross-sectional study of patients with endometrial cancer referred to the Brazilian National Cancer Institute. We collected data on sociodemographic variables, smoking, co-morbidities, physical activity level, menopausal status, and tumor characteristics (histological subtype, stage, and tumor grade). In addition, weight, height, and waist circumference were measured. Laboratory evaluation included lipid profile, fasting blood glucose and insulin, and C-reactive protein. Insulin resistance was estimated by the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Characterization of metabolic syndrome and cardiovascular risk profile was performed. Binary logistic regression models were used to test the association between metabolic syndrome and its metabolic parameters, HOMA-IR, and C-reactive protein with tumor grade. RESULTS: We included a total of 313 patients, 245 (78.3%) aged <65 years, 262 (83.7%) with endometrioid adenocarcinoma, 193 (61.7%) early stage, and 201 (64.2%) with lower tumor grade (G1 and G2). Metabolic syndrome, insulin resistance, and low levels of leisure-time physical activity were highly prevalent (90.7%). In binary logistic regression models, an association was observed between HOMA-IR and lower tumor grade (p<0.05), while high-grade tumors were associated with the highest C-reactive protein values (p<0.05). CONCLUSION: The main finding of this study was the association between insulin resistance and low-grade tumors, and the association between high C-reactive protein levels and high-grade tumors.