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1.
J. optom. (Internet) ; 13(4): 257-261, oct.-dic. 2020.
Artigo em Inglês | IBECS | ID: ibc-193462

RESUMO

The pandemic of the severe acute respiratory syndrome disease caused by the new coronavirus SARS-CoV-2 (COVID-19), had profound impact in many countries and their health care systems. Regarding Portugal, a suppression strategy with social distancing was adopted, attempting to break the transmission chains, bending the epidemy curve and reducing mortality. These measures seek to prevent an eventual National Health Service over-running, enforcing the suspension of all elective and non-urgent health care. Despite the success in so far, there is a consensus on the need to recover the previous level of health care provision and further enhance it. The Portuguese National Health Service, as a public, universal access, health care system funded by the State proved, in this context, its importance and relevance to the Portuguese population. However, long standing issues, such as the pre pandemic over long waiting lists for hospital ophthalmology attendance, whose determinants are fully identified but still unmet, emerge amplified from this pandemic. The lack of primary eye care in the National Health Service is a significant bottleneck, placing a huge stress on hospital-based care. An exclusive ophthalmologist's center care was over-runned before pandemic and will be even more so. The optometrist's exclusion from differentiated, multisectoral and multidisciplinary eye care teams remains the main hurdle to overcome and insure universal eye care in Portugal. National Health Service highlights the consequences of an overcome model. Universal eye care more than ever demands an evidence-based, integrated approach with primary eye care, in the community, on time and of proximity


La pandemia del síndrome respiratorio agudo grave causado por el nuevo coronavirus SARS-CoV-2 (COVID-19) ha tenido amplias repercusiones en muchos países y en sus sistemas sanitarios. En Portugal, se ha adoptado una estrategia de contención basada en el distanciamiento social, con la cual se ha intentado cortar las cadenas de transmisión, frenar la curva de la epidemia y reducir la mortalidad. Con estas medidas se trataba de evitar un eventual desbordamiento del Servicio Nacional de Salud y se imponía la suspensión de toda la atención médica programada, que no fuera urgente. A pesar del éxito logrado hasta este momento, existe consenso sobre la necesidad de recuperar el nivel anterior de atención médica y fomentar su mejora. El Servicio Nacional de Salud de Portugal, como sistema sanitario público y de acceso universal, a cargo del Estado, ha demostrado, en este contexto, su importancia y pertinencia para la población portuguesa. Sin embargo, los problemas que acarrea desde hace mucho tiempo, como las largas listas de espera, anteriores a la pandemia, en la asistencia oftalmológica hospitalaria, cuyos factores determinantes están completamente identificados, pero que continúan sin solución, se han visto agravados a resultas de esta pandemia. La falta de atención primaria oftalmológica en el Servicio Nacional de Salud es un importante cuello de botella, que ejerce una enorme presión en la atención hospitalaria. La atención de un centro exclusivamente oftalmológico estaba desbordada antes de la pandemia y lo estará aún más después de esta. La exclusión de los optómetras de los equipos de atención oftalmológica diferenciados, multisectoriales y multidisciplinarios continúa siendo el principal obstáculo que debe superar y asegurar la atención oftalmológica universal en Portugal. El Servicio Nacional de Salud hace hincapié en las consecuencias de un modelo superado. La atención oftalmológica universal exige, más que nunca, un enfoque integral basado en la evidencia para abordar la atención primaria oftalmológica en la comunidad, puntual y de proximidad


Assuntos
Humanos , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Pandemias , Sistemas de Saúde , Serviços de Saúde Ocular , Assistência ao Paciente/normas , Portugal/epidemiologia
2.
Cien Saude Colet ; 25(suppl 2): 4197-4200, 2020 Oct.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33027356

RESUMO

Coronavirus disease 2019 made us question daily practices, such as the simple handshake. It also raised some ethical and legal issues. Are the ethical principles, that should guide the provision of individualized care, being fulfilled? Will we, as health professionals, be able to provide patients with instruments so that they can fully exercise their autonomy? The guarantee of necessary security solutions, to reduce the risk of contagion in the provision of care, safeguards the principle of non-maleficence. However, the risk of contagion is impossible to completely eliminate, and there is a residual risk associated with the use of physical facilities in healthcare services. But, shouldn't the decision to take that risk be the subject of the patient's free and informed will? The incorporation of telemedicine platforms is ideal for managing several challenges posed by COVID-19, such as the decrease in face-to-face health care assistance. Can the patient really decide how he prefers to be consulted, or are we imposing the consultation model? There have been profound changes in healthcare systems. However, one must remember that there are ethical principles of biomedicine, that should always prevail?


Assuntos
Infecções por Coronavirus/epidemiologia , Direitos do Paciente , Autonomia Pessoal , Pneumonia Viral/epidemiologia , Betacoronavirus , Confidencialidade , Humanos , Programas de Rastreamento , Pandemias , Preferência do Paciente , Portugal , Telemedicina
3.
F1000Res ; 9: 283, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32983416

RESUMO

Coronavirus disease 2019 (COVID-19) is a worldwide pandemic that has been affecting Portugal since 2 March 2020. The Portuguese government has been making efforts to contradict the exponential growth through social isolation measures. We have developed a mathematical model to predict the impact of such measures in the number of infected cases and peak of infection. We estimate the peak to be around 2 million infected cases by the beginning of May if no additional measures are taken. The model shows that current measures effectively isolated 25-30% of the population, contributing to some reduction on the infection peak. Importantly, our simulations show that the infection burden can be further reduced with higher isolation degree, providing information for a second intervention.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Betacoronavirus , Controle de Doenças Transmissíveis , Infecções por Coronavirus/prevenção & controle , Previsões , Humanos , Modelos Teóricos , Pandemias/prevenção & controle , Cooperação do Paciente , Pneumonia Viral/prevenção & controle , Portugal/epidemiologia
4.
Biomed Res Int ; 2020: 8397053, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33029526

RESUMO

Introduction: The Portuguese healthcare system had to adapt at short notice to the COVID-19 pandemic. We implemented workflow changes to our molecular pathology laboratory, a national reference center, to maximize safety and productivity. We assess the impact this situation had on our caseload and what conclusions can be drawn about the wider impact of the pandemic in oncological therapy in Portugal. Material and Methods. We reviewed our database for all oncological molecular tests requested between March and April of 2019 and 2020. For each case, we recorded age, sex, region of the country, requesting institution, sample type, testing method, and turnaround time (TAT). A comparison between years was made. Results: The total number of tests decreased from 421 in 2019 to 319 in 2020 (p = 0.0027). The greatest reduction was in clinical trial-related cases. Routine cases were similar between years (267 vs. 256). TAT was higher in 2019 (mean 15 days vs. 12.3 days; p = 0.0003). Medium- to large-sized public hospitals in the north of the country were mostly responsible for the reduction in cases (p = 0.0153). Conclusions: Case reduction was observed at hospitals that have mostly been involved in the treatment of COVID-19 and in the north of the country, the region worst-hit by the pandemic. Similar to other studies, our TAT decreased, even with a similar number of routine cases. Thus, we conclude that it is possible to successfully adapt the workflow of a molecular pathology laboratory to new safety standards without losing efficiency.


Assuntos
Infecções por Coronavirus/epidemiologia , Oncologia , Técnicas de Diagnóstico Molecular , Patologia Molecular , Pneumonia Viral/epidemiologia , Betacoronavirus , Humanos , Laboratórios , Pessoal de Laboratório , Técnicas de Diagnóstico Molecular/estatística & dados numéricos , Programas Nacionais de Saúde , Pandemias , Portugal/epidemiologia , Fluxo de Trabalho
5.
Zootaxa ; 4810(3): zootaxa.4810.3.11, 2020 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-33055739

RESUMO

A checklist of the tephritid fauna (Diptera: Tephritidae) from Madeira archipelago is presented, including 17 known species and new distribution records for Porto Santo and Desertas Islands. An identification key to Madeira Tephritidae species with detailed illustrations is also provided. A new species of Oedosphenella Frey 1936, discovered in Madeira Island in 2004, is described as Oedosphenella bob sp. n. This genus is redefined and a key to the known species is provided. Comparative morphological analysis revealed that Bevismyia basuto Munro 1957 from Malawi should be included in the genus Oedosphenella. Therefore, we consider the genus name Oedosphenella Frey 1936 to be a senior synonym of Bevismyia Munro 1957 syn.n.


Assuntos
Tephritidae , Animais , Drosophila , Portugal
6.
Zootaxa ; 4790(2): zootaxa.4790.2.1, 2020 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-33055838

RESUMO

Portugal is home to a rich but understudied bee fauna that was recently comprehensively documented for the first time. As part of ongoing work to improve the knowledge of Portuguese bees, efforts have been made to survey poorly recorded parts of the country and to continue to review existing material in museum collections. These efforts have resulted in 28 species newly discovered in Portugal, as well as eight species added from the literature and two taxa recently raised to full species status. Three additional species, Andrena (Lepidandrena) baetica spec. nov., Andrena (Micrandrena) omnilaevis spec. nov., and Andrena (Notandrena) foeniculae spec. nov. are described from material collected in southern Iberia, north-western Iberia, and southern Iberia, respectively. Andrena omnilaevis spec. nov. is the new name for north-western Iberian material previously identified as Andrena (Micrandrena) semilaevis Pérez. The male of Stelis hispanica Dusmet, previously only known from the holotype female, was also found and is described here. The taxon Andrena (Melandrena) limata mixtura Warncke has been various treated as a subspecies of A. limata Smith or A. nitida Müller. Examination of the holotype from Portugal shows that it actually belongs in its original combination Andrena limata comb. nov., and that true A. nitida is not present in Portugal. Seven additional species have been removed from the total due to misidentification or uncertainty. We also present discussion on the status of species complexes present in Portugal, and review species doubtfully recorded from the country. Altogether, this work increases the number of bee species recorded from mainland Portugal from 680 to 712, and to 722 for the country as a whole when including the faunas of the Madeira and Azores archipelagos.


Assuntos
Dípteros , Himenópteros , Animais , Abelhas , Feminino , Masculino , Museus , Portugal
7.
Rev Lat Am Enfermagem ; 28: e3372, 2020.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-33084775

RESUMO

OBJECTIVE: to understand the referral to the National Network of Integrated Continuous Care, from the perspective of nurses who work in this care context. METHOD: an exploratory and descriptive study with a qualitative approach, with data collection between July and September 2019 through interviews with 12 nurses who work in Integrated Continuous Care Teams, in Northern Portugal. The content analysis technique was used to analyze the statements. RESULTS: the professionals revealed that there are difficulties and constraints in the process of referring users to the National Network of Integrated Continuous Care. The process is bureaucratic, complex, and time-consuming, conditioning user accessibility to timely care. CONCLUSION: the referral process is a very bureaucratic and time-consuming procedure, which not only conditions and delays users' access to the National Network of Integrated Continuous Care network, contributing to the worsening of the clinical status of some patients. The number of professionals is insufficient, inducing the demand for services through urgency. The focus on primary care should seek to improve inequalities in access, compete for more equitable and accessible care, generating more quality in health care.


Assuntos
Prestação Integrada de Cuidados de Saúde , Encaminhamento e Consulta , Humanos , Portugal , Atenção Primária à Saúde , Fatores Socioeconômicos
8.
Einstein (Sao Paulo) ; 18: eAO5539, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33053019

RESUMO

OBJECTIVE: To translate and make cross-cultural adaptation of NECPAL CCOMS-ICO© tool to Portuguese, and to analyze its semantic validity. METHODS: A methodological research about NECPAL CCOMS-ICO© tool cross-cultural adaptation, translated from Spanish into Portuguese and measurement of semantic validity. The cross-cultural adaptation process was conducted according to Beaton recommendations, including translation, translation synthesis, back-translation, and analysis of semantic, idiomatic, conceptual, and cultural equivalence of translated and back-translated tool versions, resulting in a pre-final version, which was submitted to a pre-test (n=35). Contend Validity Index was calculated to analyze semantic validity. RESULTS: Cross-cultural adaptation process allowed us to prepare the final version of this tool, which was named NECPAL-BR. Collected data from pre-testing step enabled the analysis of semantic validity. The Content Validity Index observed at this step was 0.94. CONCLUSION: The semantic validity of the tool in its Portuguese version was confirmed; therefore, it may assist in screening chronic progressive disease patients, aiming to provide early palliative care. It may also be used to develop clinical and team performance indicators, and be employed as a care management tool designed to optimize resources.


Assuntos
Comparação Transcultural , Cuidados Paliativos/normas , Semântica , Inquéritos e Questionários/normas , Humanos , Portugal , Reprodutibilidade dos Testes , Traduções
9.
Rev Bras Epidemiol ; 23: e200100, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33053093

RESUMO

OBJECTIVE: The assessment of the degree to which health professionals, workers and organizations are ready to implement changes in health services deserves special attention, especially related to new technologies, public policies and innovation. The objectives of this study were to conduct a Brazilian Portuguese Brazil cross-cultural adaptation of the ORIC questionnaire and to initiate the study of its psychometric properties. METHODS: Through a cross-sectional study, the Organizational Readiness for Implementing Change (ORIC) questionnaire, containing 12 questions, was translated and later applied to a sample of workers from traditional primary health care units undergoing transformation to family health units. Statistical analysis included Cronbach's alpha, exploratory and confirmatory factor analysis by structural equation model using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. RESULTS: Workers from ten health units participated in the study (n = 150). The analysis confirmed two main factors (Effectiveness and Commitment) with Eigenvalues > 1. Rotation by the orthogonal method showed that the instrument questions confirmed the factors analyzed by the original instrument. The total Cronbach's Alpha of ORIC was 0.94, showing excellent reliability. CONCLUSION: The Brazilian Portuguese Brazil version of the ORIC-Br questionnaire showed good psychometric properties and can be used in health services to measure organizational readiness, considered as an indicator of the potential success in implementing change.


Assuntos
Comparação Transcultural , Inovação Organizacional , Psicometria/estatística & dados numéricos , Inquéritos e Questionários/normas , Brasil , Estudos Transversais , Humanos , Portugal , Reprodutibilidade dos Testes
10.
Zootaxa ; 4838(1): zootaxa.4838.1.9, 2020 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-33056838

RESUMO

The genus Empoasca comprises more than 600 species, many of them important pests of cultivated plants. The leafhopper Empoasca fabalis DeLong, 1930 is native to the tropical and subtropical regions of America. From here, it has successfully spread to most regions of the continent. Today its range extends from the southern United States, through Central America, and the West Indies to southern South America (Cusipuma Sanchez 1993, DeLong 1930, Paradell et al. 1990, Poos Wheeler 1949, Wolcott, 1948). Outside its native area, the species was more recently recorded in the Canary Islands (Lorenzo Hermoso de Mendonza 2000) and Hawaii (Dietrich Perreira 2019). Although it is still not known to occur in the European mainland, specimens were collected in 2000 on the island of La Palma (Spain) (Lorenzo Hermoso de Mendonza, 2000). Until now, it was unknown on the island of Madeira and Portugal.


Assuntos
Hemípteros , Solanum tuberosum , Animais , Espécies Introduzidas , Portugal
11.
J Environ Manage ; 263: 110292, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32883484

RESUMO

This article analyzes different forest management strategies to meet the increasing demand of biomass for bioenergy and assesses the resulting global warming implications. Applied to maritime pine forest plantations in Portugal, the assessed strategies are: full harvest of residues (FULL); sustainable and proactive management (SMART); expansion of forest plantations on abandoned farmland (EXP); and biomass import (IMP). A dynamic CO2 inventory was obtained for each scenario using a parametric stand-level C-flux model adapted to Portuguese conditions, which was then extended to the landscape-level and coupled to a dynamic climate model. The time-adjusted absolute global warming potential (AGWP) was then calculated at both stand and landscape levels, considering the timing of all CO2 emissions and uptakes (both fossil and biogenic). To test the robustness of the findings, a sensitivity analysis was performed. Results show that, in a supply-constrained context like Portugal, SMART and EXP management strategies can provide important global warming mitigation benefits (GWPbio < 0), although their supply-response is slow (long-term strategies). On the other hand, FULL and IMP management strategies show moderate to null AGWP reduction potential (0 < GWPbio < 1), while involving other possible risks (e.g., exacerbated soil erosion, nutrient depletion or uncertain impacts abroad), but their supply-response is fast (short-term strategies). National forest regulations and energy policies should be revised to address the drawbacks related to all management strategies and to unleash the multiple environmental benefits they can provide in the short- and long-term.


Assuntos
Florestas , Aquecimento Global , Biomassa , Clima , Portugal
12.
Am J Bot ; 107(8): 1189-1197, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32864742

RESUMO

PREMISE: The mating system has profound consequences, not only for ecology and evolution, but also for the conservation of threatened or endangered species. Unfortunately, small populations are difficult to study owing to limits on sample size and genetic marker diversity. Here, we estimated mating system parameters in three small populations of an island plant using genomic genotyping. Although self-incompatible (SI) species are known to often set some self-seed, little is known about how "leaky SI" affects selfing rates in nature or the role that multiple paternity plays in small populations. METHODS: We generalized the BORICE mating system program to determine the siring pattern within maternal families. We applied this algorithm to maternal families from three populations of Tolpis succulenta from Madeira Island and genotyped the progeny using RADseq. We applied BORICE to estimate each individual offspring as outcrossed or selfed, the paternity of each outcrossed offspring, and the level of inbreeding of each maternal plant. RESULTS: Despite a functional self-incompatibility system, these data establish T. succulenta as a pseudo-self-compatible (PSC) species. Two of 75 offspring were strongly indicated as products of self-fertilization. Despite selfing, all adult maternal plants were fully outbred. There was high differentiation among and low variation within populations, consistent with a history of genetic isolation of these small populations. There were generally multiple sires per maternal family. Twenty-two percent of sib contrasts (between outcrossed offspring within maternal families) shared the same sire. CONCLUSIONS: Genome-wide genotyping, combined with appropriate analytical methods, enables estimation of mating system and multiple paternity in small populations. These data address questions about the evolution of reproductive traits and the conservation of threatened populations.


Assuntos
Paternidade , Autofertilização , Genótipo , Ilhas , Portugal , Reprodução
13.
Artigo em Inglês | MEDLINE | ID: mdl-32957702

RESUMO

Mental health effects secondary to the COVID-19 pandemic were till recently considered less important or were neglected. Portugal and Brazil are facing the pandemic in quite different ways. This study aimed to describe the mental health status of the general adult population in Portugal and Brazil during the COVID-19 pandemic and analyze the differences between the two countries. A cross-sectional quantitative study was based on an online questionnaire. Socio-demographic data were collected in addition to four validated scales: CAGE (acronym cut-annoyed-guilty-eye) Questionnaire, Satisfaction with Life Scale, Generalized Anxiety Disorder-7 and Patient Health Questionnaire-2. For each outcome, a multiple linear regression was performed. Five hundred and fifty people answered the questionnaire (435 women). The median age was 38 (Q1, Q3: 30, 47) years, 52.5% resided in Brazil and 47.5% in Portugal. The prevalence of anxiety was 71.3% (mild anxiety was present in 43.1%), the prevalence of depression was 24.7% and 23.8% of the sample had both depression and anxiety. Isolation was a significant factor for depression but not for anxiety. Well-being was below average. Mental illness was considerably higher than pre-COVID-19 levels. Portugal and Brazil will have to be prepared for future consequences of poor mental health and contribute immediate psychological support to their adult populations.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus/epidemiologia , Depressão/epidemiologia , Saúde Mental/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia , Estresse Psicológico/epidemiologia , Adulto , Ansiedade/psicologia , Betacoronavirus , Brasil/epidemiologia , Infecções por Coronavirus/psicologia , Estudos Transversais , Depressão/psicologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/psicologia , Portugal/epidemiologia
14.
Ecotoxicol Environ Saf ; 203: 110957, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-32888620

RESUMO

Due to growing commercial interest as a fishing resource and its intermediate position in the marine trophic chains as both prey and predator, cephalopods can play an important role in mercury (Hg) transfer along the marine food webs, since they can bioaccumulate this metal in its tissues. Our study aims to analyze Hg accumulation in Loligo forbesi caught in the Azores Archipelago (Portugal) quantifying Hg in different tissues (mantle and stomach), as well in the squid stomach content, in order to evaluate the efficiency of Hg transfer from prey to predator. Hg data from the tissues was used to estimate the weekly tolerable Hg intake due to squid consumption. Overall data indicate that Hg measured in the stomach tissue (0.1 ± 0.01 µg g-1) was significantly higher than Hg levels found in the mantle (0.04 ± 0.001 µg g-1) and stomach contents (0.01 ± 0.001 µg g-1). BMF (bioaccumulation factor) was >1 for all the samples, indicating a biomagnification process from prey to predator. Hg concentration in the mantle tissue was correlated with mantle size; although females present higher Hg levels than males, the difference was found to be not related to gender but rather to the fact that females had larger bodies. Finally, considering the Hg concentration found in the mantle and the permitted Hg levels, it is advisable to consume up to 1050-1890g of squid per week, according to the regulatory agencies. Thus, our results indicate that, since these doses are respected, consumption of squids from the Azorean waters do not pose a risk to humans.


Assuntos
Bioacumulação , Exposição Dietética/análise , Monitoramento Ambiental/métodos , Loligo/metabolismo , Mercúrio/metabolismo , Poluentes Químicos da Água/metabolismo , Animais , Feminino , Cadeia Alimentar , Humanos , Masculino , Mercúrio/análise , Portugal , Alimentos Marinhos/análise , Poluentes Químicos da Água/análise
15.
BMC Pulm Med ; 20(1): 240, 2020 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-32912174

RESUMO

BACKGROUND: As part of the multinational I-O Optimise research initiative, this retrospective cohort study of patients with advanced non-small cell lung cancer (NSCLC) evaluated real-world treatment patterns and survival prior to immunotherapy reimbursement in Portugal. METHODS: This study utilized a database held by IPO-Porto, Portugal's largest oncology hospital. Adult patients diagnosed with stage IIIB or IV NSCLC from January 2012 to December 2016 at IPO-Porto, with follow-up to June 2017, were included. Treatment analyses were performed from 2015 onwards. Kaplan-Meier methods were used for overall survival (OS). Factors associated with OS and systemic anti-cancer therapy (SACT) treatment were assessed using multivariate statistical models. RESULTS: Of 1524 patients diagnosed with NSCLC at IPO-Porto, 1008 patients had advanced disease (stage IIIB: 10.1%, 154/1524, stage IV: 56.0%, 854/1524). For those with advanced disease, median age was 65 years (range: 21-92) and 75.6% (762/1008) were male. Median OS (interquartile range [IQR]) was 11.4 (5.2-26.9) months for stage IIIB and 6.3 (2.4-15.0) months for stage IV. Factors associated with decreased risk of death included female sex and epidermal growth factor receptor gene (EGFR)/anaplastic lymphoma kinase gene (ALK) mutations/rearrangements; factors associated with increased risk of death included older age and stage IV disease. Among patients diagnosed in 2015 or 2016, 75.8% (297/392) received ≥1 line of SACT. Platinum-based chemotherapy was the most common first-line therapy (non-squamous cell carcinoma [NSQ]: 72.9%; squamous cell carcinoma [SQ] 87.3%, 55/63; patients with EGFR/ALK mutations/rearrangements primarily received tyrosine kinase inhibitors). The likelihood of receiving SACT was lower in older patients and those diagnosed with stage IV disease. Patients not receiving SACT had poor survival outcomes (median OS [IQR]: NSQ, 1.8 [1.1-3.1] months; SQ, 2.3 (1.3-3.4) months), while median OS (IQR) in SACT-treated patients was 12.6 (6.1-24.5) months for NSQ and 10.3 (5.7-15.9) months for SQ. CONCLUSIONS: This real-world data analysis from a large Portuguese oncology hospital demonstrates a high disease burden for advanced NSCLC in the pre-immunotherapy era, with nearly one-quarter of patients not receiving SACT. Even in patients receiving SACT, median survival was only about 1 year.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/patologia , Estudos de Coortes , Feminino , Humanos , Imunoterapia , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Portugal/epidemiologia , Padrões de Prática Médica , Estudos Retrospectivos , Taxa de Sobrevida , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
16.
Proc Biol Sci ; 287(1935): 20201791, 2020 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-32933443

RESUMO

Biological invasions have increased in the last few decades mostly due to anthropogenic causes such as globalization of trade. Because invaders sometimes cause large economic losses and ecological disturbances, estimating their origin and potential geographical ranges is useful. Drosophila subobscura is native to the Old World but was introduced in the New World in the late 1970s and spread widely. We incorporate information on adaptive genetic markers into ecological niche modelling and then estimate the most probable geographical source of colonizers; evaluate whether the genetic bottleneck experienced by founders affects their potential distribution; and finally test whether this species has spread to all its potential suitable habitats worldwide. We find the environmental space occupied by this species in its native and introduced distributions are notably the same, although the introduced niche has shifted slightly towards higher temperature and lower precipitation. The genetic bottleneck of founding individuals was a key factor limiting the spread of this introduced species. We also find that regions in the Mediterranean and north-central Portugal show the highest probability of being the origin of the colonizers. Using genetically informed environmental niche modelling can enhance our understanding of the initial colonization and spread of invasive species, and also elucidate potential areas of future expansions worldwide.


Assuntos
Espécies Introduzidas , Distribuição Animal , Ecossistema , Marcadores Genéticos , Portugal
17.
Rev Assoc Med Bras (1992) ; 66(8): 1108-1115, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32935806

RESUMO

AIM: The aim of the present study was to compare the effects of detraining on physical performance, blood pressure, biologic and anthropometric variables of hypertensive elderly individuals, grouped by two levels of previous physical activity. METHODS: A total of 87 elderly individuals (70 to 93 years old) with systolic/diastolic blood pressure levels above 120/80 mmHg who participated during 18 non-consecutive months in 2 years in physical exercise programs offered in northern Portugal communities were included in the study. Tests were performed before and after three months of no exercise. Attendance to the exercise sessions, hematological markers, cardiorespiratory function, and anthropometric variables were assessed. The results were analyzed according to the fulfillment of the WHO recommendations on moderate physical activity (at least 150 minutes/week). RESULTS: Weight, total cholesterol, and glucose were influenced by the amount of physical activity performed previously to the detraining period. After the detraining period, the total cholesterol, glucose, insulin, and weight had significant differences influenced by the amount of physical activity previously performed (p<0.05). CONCLUSIONS: The number of minutes per week of aerobic and resistance exercise training over 18 non-consecutive months was not a significant determinant factor in the development of hypertension during the three months of detraining.


Assuntos
Hipertensão , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea , Peso Corporal , Exercício Físico , Humanos , Portugal
19.
J Epidemiol Glob Health ; 10(3): 209-213, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32954711

RESUMO

BACKGROUND: One month after the first COVID-19 infection was recorded, Portugal counted 18,051 cases and 599 deaths from COVID-19. To understand the overall impact on mortality of the pandemic of COVID-19, we estimated the excess mortality registered in Portugal during the first month of the epidemic, from March 16 until April 14 using two different methods. METHODS: We compared the observed and expected daily deaths (historical average number from daily death registrations in the past 10 years) and used 2 standard deviations confidence limit for all-cause mortality by age and specific mortality cause, considering the last 6 years. An adapted Auto Regressive Integrated Moving Average (ARIMA) model was also tested to validate the estimated number of all-cause deaths during the study period. RESULTS: Between March 16 and April 14, there was an excess of 1255 all-cause deaths, 14% more than expected. The number of daily deaths often surpassed the 2 standard deviations confidence limit. The excess mortality occurred mostly in people aged 75+. Forty-nine percent (49%) of the estimated excess deaths were registered as due to COVID-19, the other 51% registered as other natural causes. CONCLUSION: Even though Portugal took early containment measures against COVID-19, and the population complied massively with those measures, there was significant excess mortality during the first month of the pandemic, mostly among people aged 75+. Only half of the excess mortality was registered as directly due do COVID-19.An Excess Mortality (EM) of 1255 deaths were estimated 1 month after the first death classified by COVID-19, and it would probably be more if the government had not taken early action.The age group where a significant increase in mortality was noted was above 75 years.51% of the EM was due to natural causes other than COVID-19.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Mortalidade , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Feminino , Humanos , Masculino , Portugal/epidemiologia
20.
Pharm. pract. (Granada, Internet) ; 18(3): 0-0, jul.-sept. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-194192

RESUMO

The central role of the Portuguese National Health Service (P-NHS) guarantees virtually free universal coverage. Key policy papers, such as the National Health Plan and the National Plan for Patient Safety have implications for pharmacists, including an engagement in medicines reconciliation. These primary health care reform, while not explicitly contemplating a role for pharmacists, offer opportunities for the involvement of primary care pharmacists in medicines management. Primary care pharmacists, who as employees of the P-NHS work closely with an interdisciplinary team, have launched a pilot service to manage polypharmacy in people living with multimorbidities, involving potential referral to community pharmacy. Full integration of community pharmacy into primary health care is challenging due to their nature as private providers, which implies the need for the recognition that public and private health sectors are mutually complementary and may maximize universal health coverage. The scope of practice of community pharmacies has been shifting to service provision, currently supported by law and in some cases, including the needle and syringe exchange program and generic substitution, remunerated. Key changes envisaged for the future of pharmacists and their integration in primary care comprise the development and establishment of clinical pharmacy as a specialization area, peer clinician recognition and better integration in primary care teams, including full access to clinical records. These key changes would enable pharmacists to apply their competence in medicines optimization for improved patient outcomes


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Assuntos
Humanos , Atenção Primária à Saúde/normas , Política de Saúde , Farmácias/normas , Farmacêuticos/normas , Assistência Farmacêutica/normas , Farmácias/organização & administração , Portugal , Assistência Farmacêutica/organização & administração , Prática Profissional , Papel Profissional
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