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Browsing ciTechCare - Artigos by Sustainable Development Goals (SDG) "17:Parcerias para a Implementação dos Objetivos"
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- O efeito do jogo na promoção do equilíbrio e na prevenção do risco de quedas em pessoas idosasPublication . Neves Rosa, Marlene Cristina; Brites, Cátia; Tarrafa, Inês; Viamonte, Miguel; Oliveira, Patrícia; Silva, CândidaIntrodução: O jogo analógico dirigido a pessoas idosas com alterações de equilíbrio e risco de queda demonstrou alguns potenciais resultados, contudo os estudos são escassos. Objetivo: O presente estudo pretendeu testar o potencial de um jogo analógico na melhoria do equilíbrio e diminuição do risco de quedas, bem como caracterizar o desempenho dos participantes no jogo e a sua relação com as variáveis de equilíbrio e risco de queda. Metodologia: Foram analisados dados recolhidos em três momentos: inicial (T0); após 6 semanas de intervenção com jogo (T1) e final (T2), após 6 semanas sem intervenção com jogo. Foram calculadas correlações entre o desempenho no jogo nas diferentes grelhas (S, M e L) e os indicadores de equilíbrio (Teste de Levantar e Ir (TUG) e teste Tinetti); estes testes foram comparados entre os períodos com e sem o jogo. Resultados: Dez pessoas idosas (87,60±7,25 anos; 8 mulheres) participaram no estudo, melhorando significativamente os valores de TUG apenas entre T0-T1 (p=0,002). Os valores do teste de Tinetti melhoraram significativamente nos dois períodos de intervenção (p=0,001; p=0,006). O desempenho na grelha L demonstrou correlação com o teste Tinetti (T0 - ρ = -0,664; p = 0,036) e com o TUG apenas na 2ª tentativa (T0; r = 0,680; p = 0,030*). Conclusão: Existe potencial benefício do jogo analógico na melhoria do risco de queda (TUG) na pessoa idosa institucionalizada. O jogo implementado, no seu nível mais exigente (grelha L), parece adequar-se ao contexto de reabilitação, promovendo aprendizagem ao longo do tempo.
- Efficacy and safety of pharmacological treatments in inclusion body myositis: a systematic reviewPublication . Santos, Eduardo José Ferreira; Farisogullari, Bayram; Yapp, Nicholas; Townsley, Hermaleigh; Sousa, Pedro; Machado, Pedro; Combe, BernardObjective: To identify the best evidence on the efficacy of treatment interventions for inclusion body myositis (IBM) and to describe their safety. Methods: Systematic review of randomised controlled trials (RCTs) of pharmacological treatments of adults with IBM, conducted according to the Cochrane Handbook, updating a previous Cochrane review. The search strategy was run on Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL, MEDLINE and EMBASE, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. Assessment of risk of bias, data extraction and synthesis were performed independently by two reviewers. Data pooled in statistical meta-analyses, if possible. Results: From a total of 487 records, 48 were selected for full-text review, 14 fulfilled the inclusion criteria, but only 2 RCTs were included in meta-analyses due to clinical heterogeneity (different drug interventions or dosages). Treatments included various immunosuppressive and immunomodulatory agents, alongside interventions modulating muscle growth and protein homoeostasis. Efficacy was assessed across multiple outcomes, namely muscle strength, physical function, mobility and muscle trophicity. Trials of methotrexate (MTX), intravenous immunoglobulin, interferon beta-1a and MTX, MTX and anti-T-lymphocyte immunoglobulin, oxandrolone, MTX and azathioprine, bimagrumab, arimoclomol, and sirolimus provided low-quality to high-quality evidence of having no effect on the progression of IBM. Conclusions: Drug interventions for IBM were not effective for most of the outcomes of interest. We observed inconsistency of outcome measures across trials. More RCTs are needed, of adequate size and duration, and using a standardised set of outcome measures.
- Multidrug resistance assessment of indoor air in Portuguese long-term and acute healthcare settingsPublication . Santos-Marques, C.; Teixeira, C.; Pinheiro, R.; Brück, W. M.; Pereira, Sónia Gonçalves; dos Santos Marques, Catarina; Silva Teixeira, Camila; Pinheiro, Rafael; Gonçalves Pereira, SóniaBackground: Knowledge about air as a pool of pathogens and multidrug resistance (MDR) in healthcare units apart from hospitals is scarce. Aim: To investigate these features in a Portuguese long-term healthcare unit (LTHU) and a central hospital (CH). Methods: Air samples were collected and their microbial load (bacteria and fungi) determined. Bacterial isolates were randomly selected for further characterization, particularly identification by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry, antimicrobial susceptibility testing, and polymerase chain reaction screening of extended-spectrum b-lactamases, carbapenemase genes and mecA gene, with RAPD profile assessment of positive results of the latter. Findings: A total of 192 samples were collected (LTHU: 86; CH: 106). LTHU showed a statistically significantly higher bacterial load. CH bacteria and fungi loads in inpatient sites were statistically significantly lower than in outpatients or non-patient sites. A total of 164 bacterial isolates were identified (MALDI-TOF: 78; presumptively: 86), the majority belonging to Staphylococcus genus (LTHU: 42; CH: 57). The highest antimicrobial resistance rate was to erythromycin and vancomycin the least, in both settings. Eighteen isolates (11%) were classified as MDR (LTHU: 9; CH: 9), with 7 MDR Staphylococcus isolates (LTHU: 4; CH: 3) presenting mecA. Nine non-MDR Staphylococcus (LTHU: 5; CH: 4) also presented mecA. Conclusion: The current study highlights that healthcare unit indoor air can be an important pool of MDR pathogens and antimicrobial resistance genes. Also, LTHUs appear to have poorer air quality than hospitals, as well as supportive areas compared to curative care areas. This may suggest possible yet unknown routes of infection that need to be explored.