Pub Date : 2023-03-01DOI: 10.1097/j.pbj.0000000000000200
Sofia Tavares-Almeida, Diana Moura, Nuno Madeira, Margarida Figueiredo-Braga
Background: University students are a risk population for mental health problems. This study aims to evaluate the psychological burden of the COVID-19 pandemic in Portuguese university students and to uncover factors associated with worse psychological indicators.
Methods: We used an online survey to perform a cross-sectional study that evaluated students' perceptions, lifestyle, and psychological well-being during the pandemic. Depression symptoms and risk were measured by the Patient Health Questionnaire-9, and resilience levels were quantified by the 9-item Resilience Evaluation Scale. Self-perceived levels of anxiety and current mental health status were evaluated.
Results: From a population of around 30,000 students invited to participate, 1751 responses were obtained and 1447 were included. Most students were female (72.3%) and were taking a master's degree (58.4%). The course with more responses was engineering (25.5%), followed by medicine (13.2%). The prevalence rates for higher anxiety levels, depression risk, and low resilience levels were 66.7%, 37.3%, and 24.9%, respectively. The factors associated with better psychological outcomes were being male, spending more time studying, having a job, performing extracurricular activities, physical exercise, and relaxing activities. By contrast, spending more time watching news, difficulty accessing online lectures, and absence of contact with family or friends were associated with worse psychological indicators. Although all courses presented substantial levels of depressive symptoms, architectures/arts, sciences, and humanities scored significantly more in the depression scale. Medicine students had significantly higher resilience levels compared with other courses.
Conclusions: Our findings identify factors associated with worse psychological outcomes and can be used to create protective measures for the mental health of university students during current and future pandemics.
{"title":"Psychological burden in Portuguese university students during the COVID-19 pandemic.","authors":"Sofia Tavares-Almeida, Diana Moura, Nuno Madeira, Margarida Figueiredo-Braga","doi":"10.1097/j.pbj.0000000000000200","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000200","url":null,"abstract":"<p><strong>Background: </strong>University students are a risk population for mental health problems. This study aims to evaluate the psychological burden of the COVID-19 pandemic in Portuguese university students and to uncover factors associated with worse psychological indicators.</p><p><strong>Methods: </strong>We used an online survey to perform a cross-sectional study that evaluated students' perceptions, lifestyle, and psychological well-being during the pandemic. Depression symptoms and risk were measured by the Patient Health Questionnaire-9, and resilience levels were quantified by the 9-item Resilience Evaluation Scale. Self-perceived levels of anxiety and current mental health status were evaluated.</p><p><strong>Results: </strong>From a population of around 30,000 students invited to participate, 1751 responses were obtained and 1447 were included. Most students were female (72.3%) and were taking a master's degree (58.4%). The course with more responses was engineering (25.5%), followed by medicine (13.2%). The prevalence rates for higher anxiety levels, depression risk, and low resilience levels were 66.7%, 37.3%, and 24.9%, respectively. The factors associated with better psychological outcomes were being male, spending more time studying, having a job, performing extracurricular activities, physical exercise, and relaxing activities. By contrast, spending more time watching news, difficulty accessing online lectures, and absence of contact with family or friends were associated with worse psychological indicators. Although all courses presented substantial levels of depressive symptoms, architectures/arts, sciences, and humanities scored significantly more in the depression scale. Medicine students had significantly higher resilience levels compared with other courses.</p><p><strong>Conclusions: </strong>Our findings identify factors associated with worse psychological outcomes and can be used to create protective measures for the mental health of university students during current and future pandemics.</p>","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 2","pages":"e200"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a9/0c/pj9-8-e200.PMC10158877.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9783547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1097/j.pbj.0000000000000212
Rita Rego, Margarida Madeira, Eugeniu Gisca, Daniela Brigas, Ana Vigário, Arsénio Barbosa, Sílvia Pereira, Marta Soares, Ana Macedo
{"title":"Characterization and prognosis of very elderly patients with anemia, cardio-cerebrovascular disease, and iron deficiency in four Portuguese hospitals.","authors":"Rita Rego, Margarida Madeira, Eugeniu Gisca, Daniela Brigas, Ana Vigário, Arsénio Barbosa, Sílvia Pereira, Marta Soares, Ana Macedo","doi":"10.1097/j.pbj.0000000000000212","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000212","url":null,"abstract":"","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 2","pages":"e212"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9799452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1097/j.pbj.0000000000000206
Habeeb Salami
Antimicrobial resistance (AMR) is a global health problem. Antibiotics that were once very efficient in treating bacterial infections are now inactive. When antibiotics were discovered about, we believed the battle against infectious diseases has been won but the age of antibiotics, spanning only 80 years, is now entering a period of progressive and widespread emergence of drugresistant organisms that threaten to bring this era to an end. The problem of AMR is serious because bacteria are almost resistant to all available classes of antibiotics, and a new pipeline of antibiotics is not produced. Although AMR is a natural phenomenon, we are responsible for accelerating it. The increased and unguided use of antibiotics across multiple sectors, that is, humans, animals, and agriculture, has further exacerbated this problem. When microorganisms are facedwith antibiotics selection pressure, they enhance their fitness by acquiring resistance determinants through mechanisms such as horizontal gene transfer (transduction, conjugation, and transformation) and then sharing them with other bacteria and by other mechanisms, for example, gene overexpression and silencing and phase variation. The effect of AMR in Africa could be catastrophic because of the poor health systems and infrastructure, inadequate surveillance of infectious diseases, and the inadequate health personnel, which is motivated partly by the mass exodus of health practitioners from Africa to foreign continents to seek greener pastures. The higher burden of AMR in low-resource health systems highlights the importance—both for themanagement of individual patients and for the surveillance of AMR—of welldeveloped national action plans and laboratory infrastructure in all African regions and countries. Surprisingly,Africawas one of the least affected continents indirect morbidity, mortality, and absolute cumulative cases of COVID-19. This is because most countries in Africa reacted quickly and imposed tough restrictions such as banning local and international travel, closing industries, schools and universities, banning public transportation, and restricting healthcare to emergency mode. Some of these countries in Africa adopted guidance from the WHO, stratifying their COVID-19 public health responses into several pillars, including surveillance, case management, infection prevention and control, ports of entry, logistics, security, risk communication and community engagement, and laboratory. Taking a cue fromhowAfrica handled theCOVID-19 pandemic, AMR can also be tackled effectively by adopting the strategies used in combating the COVID-19 pandemic. The report byMurray et al estimated that Africa had the highest number of deaths attributable to AMR infections, that is, 27.3 deaths per 100,000 compared with other continents, and surprisingly, Africa had a lower number of COVID-19 deaths. If the strategies such as surveillance, infection prevention, community engagement, collaborative research an
{"title":"Tackling antimicrobial resistance in Africa, adopting lessons from Africa's success in navigating the COVID-19 pandemic.","authors":"Habeeb Salami","doi":"10.1097/j.pbj.0000000000000206","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000206","url":null,"abstract":"Antimicrobial resistance (AMR) is a global health problem. Antibiotics that were once very efficient in treating bacterial infections are now inactive. When antibiotics were discovered about, we believed the battle against infectious diseases has been won but the age of antibiotics, spanning only 80 years, is now entering a period of progressive and widespread emergence of drugresistant organisms that threaten to bring this era to an end. The problem of AMR is serious because bacteria are almost resistant to all available classes of antibiotics, and a new pipeline of antibiotics is not produced. Although AMR is a natural phenomenon, we are responsible for accelerating it. The increased and unguided use of antibiotics across multiple sectors, that is, humans, animals, and agriculture, has further exacerbated this problem. When microorganisms are facedwith antibiotics selection pressure, they enhance their fitness by acquiring resistance determinants through mechanisms such as horizontal gene transfer (transduction, conjugation, and transformation) and then sharing them with other bacteria and by other mechanisms, for example, gene overexpression and silencing and phase variation. The effect of AMR in Africa could be catastrophic because of the poor health systems and infrastructure, inadequate surveillance of infectious diseases, and the inadequate health personnel, which is motivated partly by the mass exodus of health practitioners from Africa to foreign continents to seek greener pastures. The higher burden of AMR in low-resource health systems highlights the importance—both for themanagement of individual patients and for the surveillance of AMR—of welldeveloped national action plans and laboratory infrastructure in all African regions and countries. Surprisingly,Africawas one of the least affected continents indirect morbidity, mortality, and absolute cumulative cases of COVID-19. This is because most countries in Africa reacted quickly and imposed tough restrictions such as banning local and international travel, closing industries, schools and universities, banning public transportation, and restricting healthcare to emergency mode. Some of these countries in Africa adopted guidance from the WHO, stratifying their COVID-19 public health responses into several pillars, including surveillance, case management, infection prevention and control, ports of entry, logistics, security, risk communication and community engagement, and laboratory. Taking a cue fromhowAfrica handled theCOVID-19 pandemic, AMR can also be tackled effectively by adopting the strategies used in combating the COVID-19 pandemic. The report byMurray et al estimated that Africa had the highest number of deaths attributable to AMR infections, that is, 27.3 deaths per 100,000 compared with other continents, and surprisingly, Africa had a lower number of COVID-19 deaths. If the strategies such as surveillance, infection prevention, community engagement, collaborative research an","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 2","pages":"e206"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ce/73/pj9-8-e206.PMC10158896.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9485686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1097/j.pbj.0000000000000205
Mariana L Matos, Paula C F Matias, Carlos M S P M Grijó, Rita B Gouveia, Marta F S Patacho, António J S Almeida
Introduction Epipericardial fat necrosis (EFN), first described in 1957, is an inflammatory process that affects the epipericardial fat. It is a benign and self-limited cause of acute chest pain. Chest computed tomography (CT) is the preferred imaging method to diagnose this condition. Its noninvasive treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) leads to the resolution of the symptoms. This case report illustrates the clinical presentation of this disease.
{"title":"Epipericardial fat necrosis: a case report of an underdiagnosed disease.","authors":"Mariana L Matos, Paula C F Matias, Carlos M S P M Grijó, Rita B Gouveia, Marta F S Patacho, António J S Almeida","doi":"10.1097/j.pbj.0000000000000205","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000205","url":null,"abstract":"Introduction Epipericardial fat necrosis (EFN), first described in 1957, is an inflammatory process that affects the epipericardial fat. It is a benign and self-limited cause of acute chest pain. Chest computed tomography (CT) is the preferred imaging method to diagnose this condition. Its noninvasive treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) leads to the resolution of the symptoms. This case report illustrates the clinical presentation of this disease.","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 2","pages":"e205"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/08/65/pj9-8-e205.PMC10158854.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9799443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1097/j.pbj.0000000000000209
Miguel Martins de Carvalho, Ricardo Alves Pinto, Tânia Proença, Delfim Souteiro, Luís Adão, Filipe Macedo, Manuel Campelo
The authors present a clinical case of a 54-year-old woman without relevant medical history other than Brugada type 1 pattern in the electrocardiogram, without chronic medica-tion, who was referred for the cardiology outpatient clinic with palpitations. She had a strong family history of Brugada syndrome, but no history of sudden death, and she never had syncope. A transthoracic echocardiogram was performed, ruling out structural heart disease. Blood samples were analyzed, without thyroid function or electrolyte abnormalities. A 24-hour Holter examination was performed (digital Philips Zymed Holter, Model 1810 Plus Software, Philips Medical Systems) that revealed nocturnal periods of first-degree atrio-ventricular block (AVB) with a markedly variable PR interval and without nonconducted P waves; no other abnormalities were seen; the patient was asymptomatic. The P wave and QRS morphology were the same throughout the examination. The PR interval either increased or decreased, but it was always followed by a QRS complex. The number of P waves was the same as the QRS complexes. There was no relation between the PR interval variability and heart rate or circadian predomi-nance. The patient is kept under follow-up in the outpatient clinic, uneventful. No genetic test was performed. First-degree AVB is typically a benign situation 1 ; however, it is associated with increased incidence of atrial fibrillation, heart failure, and mortality during follow-up. 2 In some clinical settings, it can even be associated with markedly decreased survival. 3 Some data point out that first-degree AVB on a basal ECG is an independent predictor of malignant arrhythmic events in Brugada syndrome
{"title":"Marked PR interval variability in a patient with Brugada syndrome.","authors":"Miguel Martins de Carvalho, Ricardo Alves Pinto, Tânia Proença, Delfim Souteiro, Luís Adão, Filipe Macedo, Manuel Campelo","doi":"10.1097/j.pbj.0000000000000209","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000209","url":null,"abstract":"The authors present a clinical case of a 54-year-old woman without relevant medical history other than Brugada type 1 pattern in the electrocardiogram, without chronic medica-tion, who was referred for the cardiology outpatient clinic with palpitations. She had a strong family history of Brugada syndrome, but no history of sudden death, and she never had syncope. A transthoracic echocardiogram was performed, ruling out structural heart disease. Blood samples were analyzed, without thyroid function or electrolyte abnormalities. A 24-hour Holter examination was performed (digital Philips Zymed Holter, Model 1810 Plus Software, Philips Medical Systems) that revealed nocturnal periods of first-degree atrio-ventricular block (AVB) with a markedly variable PR interval and without nonconducted P waves; no other abnormalities were seen; the patient was asymptomatic. The P wave and QRS morphology were the same throughout the examination. The PR interval either increased or decreased, but it was always followed by a QRS complex. The number of P waves was the same as the QRS complexes. There was no relation between the PR interval variability and heart rate or circadian predomi-nance. The patient is kept under follow-up in the outpatient clinic, uneventful. No genetic test was performed. First-degree AVB is typically a benign situation 1 ; however, it is associated with increased incidence of atrial fibrillation, heart failure, and mortality during follow-up. 2 In some clinical settings, it can even be associated with markedly decreased survival. 3 Some data point out that first-degree AVB on a basal ECG is an independent predictor of malignant arrhythmic events in Brugada syndrome","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 2","pages":"e209"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9485688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1097/j.pbj.0000000000000202
Pedro Brandão, Nathan Ceschin
The ROPA (Reception of Oocytes from PArtner) method, also known as lesbian shared IVF (in vitro fertilization), is an assisted reproduction technique for female couples, in which one of the women provides the oocytes (genetic mother) and the other receives the embryo and gestates (gestational mother). As a double parented method, it is the only way lesbian women may biologically share motherhood. This is a narrative review of data concerning ROPA published in PubMed, Scopus, and Cochrane Library. A total of 35 articles were included, 10 about motivations for undergoing ROPA, 13 about ethics or legislation, 4 about motherhood, and 8 studies reporting clinical outcomes. Despite being used for more than a decade, there is a paucity of data regarding this technique in scientific literature. Most women choose this technique to share biological motherhood, but medical issues may also justify its use. Many ethical and legal issues are still to be solved. Despite the small number of studies, data regarding the outcomes of this technique and the resulting motherhood are reassuring.
{"title":"Lesbian shared IVF: the ROPA method: a systematic review.","authors":"Pedro Brandão, Nathan Ceschin","doi":"10.1097/j.pbj.0000000000000202","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000202","url":null,"abstract":"<p><p>The ROPA (Reception of Oocytes from PArtner) method, also known as lesbian shared IVF (in vitro fertilization), is an assisted reproduction technique for female couples, in which one of the women provides the oocytes (genetic mother) and the other receives the embryo and gestates (gestational mother). As a double parented method, it is the only way lesbian women may biologically share motherhood. This is a narrative review of data concerning ROPA published in PubMed, Scopus, and Cochrane Library. A total of 35 articles were included, 10 about motivations for undergoing ROPA, 13 about ethics or legislation, 4 about motherhood, and 8 studies reporting clinical outcomes. Despite being used for more than a decade, there is a paucity of data regarding this technique in scientific literature. Most women choose this technique to share biological motherhood, but medical issues may also justify its use. Many ethical and legal issues are still to be solved. Despite the small number of studies, data regarding the outcomes of this technique and the resulting motherhood are reassuring.</p>","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 2","pages":"e202"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9809991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1097/j.pbj.0000000000000210
Vincent Zimmer
To the Editor: Percutaneous endoscopic gastrostomy (PEG) remains the standard enteral nutrition access in clinical practice with limited complication potential. Beyond mushroom and/or disk-tip tubes (pull technique), in the introducer technique balloon-type G-tubes are implanted, warranting regular, often nurse-led exchanges. Herein, two novel complications related to tube exchange are presented. A frail male patient with advanced diffuse idiopathic skeletal hyperostosis (DISH)–related dysphagia reported on worsening enteral nutrition tolerance (intermittent administration) due to abdominal pain since the last bedside tube exchange by a specialized nutrition team in the nursing home. On endoscopy, transpyloric misplacement likely related to inadvertent duodenal guidewire insertion (Fig. 1A), resistant to repositioning by external traction (Fig. 1B), was detected. Endoscopy-directed repositioning was easily performed after balloon deflation and withdrawal into the stomach, and other potential causes for deterioration of nutrition tolerance, such as ulcer disease, were excluded. In retrospective, this
{"title":"Transpyloric misplacement and intramural dislocation: two novel complications related to balloon-type G-tubes.","authors":"Vincent Zimmer","doi":"10.1097/j.pbj.0000000000000210","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000210","url":null,"abstract":"To the Editor: Percutaneous endoscopic gastrostomy (PEG) remains the standard enteral nutrition access in clinical practice with limited complication potential. Beyond mushroom and/or disk-tip tubes (pull technique), in the introducer technique balloon-type G-tubes are implanted, warranting regular, often nurse-led exchanges. Herein, two novel complications related to tube exchange are presented. A frail male patient with advanced diffuse idiopathic skeletal hyperostosis (DISH)–related dysphagia reported on worsening enteral nutrition tolerance (intermittent administration) due to abdominal pain since the last bedside tube exchange by a specialized nutrition team in the nursing home. On endoscopy, transpyloric misplacement likely related to inadvertent duodenal guidewire insertion (Fig. 1A), resistant to repositioning by external traction (Fig. 1B), was detected. Endoscopy-directed repositioning was easily performed after balloon deflation and withdrawal into the stomach, and other potential causes for deterioration of nutrition tolerance, such as ulcer disease, were excluded. In retrospective, this","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 2","pages":"e210"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d2/8e/pj9-8-e210.PMC10158886.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9799449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1097/j.pbj.0000000000000204
Gonçalo M C Rodrigues, Maria J Salgado, Ana P Fernandes, Ana R Jaime, Ana M Macedo, Manuel Salavessa
The importance of improving clinical research is a consensual topic. Observational studies represent a practical approach to measuring real-world outcomes and responding to health policy directives by their descriptive nature and hypothesis generators. Thus, in the era of evidence-based medicine, the prompt approval of these studies would benefit their implementation and data collection. Thispilotstudyevaluatedtheapprovaltimesforeightobservational
{"title":"Time for implementation of local observational studies.","authors":"Gonçalo M C Rodrigues, Maria J Salgado, Ana P Fernandes, Ana R Jaime, Ana M Macedo, Manuel Salavessa","doi":"10.1097/j.pbj.0000000000000204","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000204","url":null,"abstract":"The importance of improving clinical research is a consensual topic. Observational studies represent a practical approach to measuring real-world outcomes and responding to health policy directives by their descriptive nature and hypothesis generators. Thus, in the era of evidence-based medicine, the prompt approval of these studies would benefit their implementation and data collection. Thispilotstudyevaluatedtheapprovaltimesforeightobservational","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 2","pages":"e204"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9783546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1097/j.pbj.0000000000000207
Beatriz C Lourenço, Tiago Amorim-Barbosa, Carolina Lemos, Ricardo Rodrigues-Pinto
Introduction: Proximal femur fragility fractures (PFFFs) are a growing worldwide concern. Recognizing the risk factors for subsequent fracture is essential for secondary prevention. This study aimed to analyze the risk factors for refracture and mortality rates in patients who suffered a PFFF.
Methods: Patients aged 65 years or older with PFFF who underwent surgical treatment during the year of 2017 in the same institution were retrospectively analyzed and at least four years after the index fracture were evaluated.
Results: From a total of 389 patients, 299 patients were included, with a median age of 83 years, and 81% female. Thirty-two (10.7%) suffered a refracture, with a mean time to refracture of 19.8 ± 14.80 months, being the female sex a risk factor for refracture (OR-4.69; CI [1.05-20.95]). The 1-year mortality rate was 15.4%. Seventy-three (24.4%) patients had previous fragility fractures. After the index fracture, 79% remained untreated for osteoporosis. No statistical association was found between antiosteoporotic treatment and refracture. Patients with refracture had higher prefracture functional level compared with patients without refracture (OR-1.33; CI [1.08-1.63]) and were discharged more often to rehabilitation units (31% versus 16%, P =.028). After 4 years of follow-up, patients with refracture had lower functional level compared with patients without. Chronic kidney disease was a risk factor (P = .029) for early refracture (<24 months).
Conclusion: Female sex and higher prefracture functional level may increase the risk of refracture. Chronic kidney disease was associated with a shorter refracture time. Despite having a PFFF or other fragility fractures, the majority of patients remained untreated for osteoporosis.
{"title":"Risk factors for refracture after proximal femur fragility fracture.","authors":"Beatriz C Lourenço, Tiago Amorim-Barbosa, Carolina Lemos, Ricardo Rodrigues-Pinto","doi":"10.1097/j.pbj.0000000000000207","DOIUrl":"https://doi.org/10.1097/j.pbj.0000000000000207","url":null,"abstract":"<p><strong>Introduction: </strong>Proximal femur fragility fractures (PFFFs) are a growing worldwide concern. Recognizing the risk factors for subsequent fracture is essential for secondary prevention. This study aimed to analyze the risk factors for refracture and mortality rates in patients who suffered a PFFF.</p><p><strong>Methods: </strong>Patients aged 65 years or older with PFFF who underwent surgical treatment during the year of 2017 in the same institution were retrospectively analyzed and at least four years after the index fracture were evaluated.</p><p><strong>Results: </strong>From a total of 389 patients, 299 patients were included, with a median age of 83 years, and 81% female. Thirty-two (10.7%) suffered a refracture, with a mean time to refracture of 19.8 ± 14.80 months, being the female sex a risk factor for refracture (OR-4.69; CI [1.05-20.95]). The 1-year mortality rate was 15.4%. Seventy-three (24.4%) patients had previous fragility fractures. After the index fracture, 79% remained untreated for osteoporosis. No statistical association was found between antiosteoporotic treatment and refracture. Patients with refracture had higher prefracture functional level compared with patients without refracture (OR-1.33; CI [1.08-1.63]) and were discharged more often to rehabilitation units (31% versus 16%, <i>P</i> =.028). After 4 years of follow-up, patients with refracture had lower functional level compared with patients without. Chronic kidney disease was a risk factor (<i>P</i> = .029) for early refracture (<24 months).</p><p><strong>Conclusion: </strong>Female sex and higher prefracture functional level may increase the risk of refracture. Chronic kidney disease was associated with a shorter refracture time. Despite having a PFFF or other fragility fractures, the majority of patients remained untreated for osteoporosis.</p>","PeriodicalId":74479,"journal":{"name":"Porto biomedical journal","volume":"8 2","pages":"e207"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9799450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1097/j.pbj.0000000000000208
João Vale, Luisa V Pinto, Bianca Barros, Sara Diniz, Filipe Rodrigues, Marco Marques, Jorge Belinha, Adélio Vilaça
Background: Total knee arthroplasty (TKA) is one of the most frequently performed orthopedic procedures. The correct positioning and alignment of the components significantly affects prosthesis survival. Considering the current controversy regarding the target of postoperative alignment of TKA, this study evaluated the tension at tibial component interface using two numerical methods.
Methods: The stress of the prosthesis/bone interface of the proximal tibial component was evaluated using two numerical methods: the finite element method (FEM) and the new meshless method: natural neighbor radial point interpolation method (NNRPIM). The construction of the model was based on Zimmers NexGen LPS-Flex Mobile® prosthesis and simulated the forces by using a free-body diagram.
Results: Tibiofemoral mechanical axis (TFMA) for which a higher number of nodes are under optimal mechanical tension is between 1° valgus 2° varus. For values outside the interval, there are regions under the tibial plate at risk of bone absorption. At the extremities of the tibial plate of the prosthesis, both medial and lateral, independent of the alignment, are under a low stress. In all nodes evaluated for all TFMA, the values of the effective stresses were higher in the NNRPIM when compared with the FEM.
Conclusion: Through this study, we can corroborate that the optimal postoperative alignment is within the values that are currently considered of 0 ± 3° varus. It was verified that the meshless methods obtain smoother and more conservative results, which may make them safer when transposed to the clinical practice.
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