32 results on '"Capelas, Manuel Luís"'
Search Results
2. Generating Consensus on Good Practices in the Care of Portuguese Internal Medicine Patients Facing Imminent Death: A Delphi Study.
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Carneiro, Rui, Capelas, Manuel Luís, Simões, Catarina, Freire, Elga, and Carneiro, António Henriques
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VOMITING prevention ,HOME care services ,CONSENSUS (Social sciences) ,DEATH ,RESEARCH funding ,INTERPROFESSIONAL relations ,MEDICAL prescriptions ,RESEARCH methodology evaluation ,HOSPITAL care ,DISEASE management ,QUESTIONNAIRES ,STATISTICAL sampling ,INTERNAL medicine ,PAIN ,TERMINALLY ill ,TERMINAL care ,DELPHI method ,PHYSICIANS ,DATA analysis software ,DYSPNEA ,VOMITING ,HOSPITAL wards ,NAUSEA - Abstract
Context: Modern medicine aims to ensure a world in which all people experience a good end of life as an integral part of their life journey. A good end-of-life experience means dying with dignity and receiving the best healthcare based on scientific evidence. Objective: This study aims to reach a consensus about the contents of a comprehensive instrument based on the 10/40 Model of the International Collaborative for the Best Care for the Dying Person for evaluating inpatients facing imminent death in Portuguese internal medicine wards and a proposal for anticipatory medication for symptom control in inpatient and home care settings. Methods: We employed the Delphi method and conducted various rounds of questionnaire administration to 23 Portuguese internists competent in palliative medicine. Data were obtained in July and September of 2022. Results: Consensus was reached among the expert panel on the diagnostic, initial assessment, monitoring, and after-death care items of the tool, with minor adjustments to wording or content. However, it was not possible to reach a consensus on most of the proposals presented for anticipatory medication for symptomatic control. Conclusion: We present the consensus about the contents of a comprehensive instrument for evaluating inpatients facing imminent death in Portuguese internal medicine wards. Best practices in this setting were defined from the point of view of internists with expertise in palliative care. However, the best pharmacological practices still require further reviews of the literature and consensus. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Avoidable emergency admissions: defining the concept.
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Afonso, Tânia dos Santos, Martins, Lurdes, and Capelas, Manuel Luís
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PSYCHOLOGY of the terminally ill ,CONSENSUS (Social sciences) ,COMMUNITY support ,PATIENTS ,PALLIATIVE treatment ,CHRONIC pain ,HOSPITAL admission & discharge ,QUESTIONNAIRES ,HOSPITAL emergency services ,LITERATURE reviews ,CONCEPTS ,DELPHI method - Abstract
Background: The transfer of end-of-life patients to hospital via admission to an emergency service mainly happens because of a lack of community support nearby and a lack of resources in palliative care. Aims: This study aimed to define the concept of avoidable admission to an emergency department for palliative patients. Methods: An integrative literature review was performed. The results of this were put to a panel of palliative care experts via a Delphi process to determine their consensus and agreement with the statements. Findings: The results of the two-step Delphi process reached a high level of consensus and agreement that patients with palliative needs accompanied by home palliative care teams should not go to the emergency department. There was a low level of consensus and agreement about the appropriate admission of a patient in pain in the absence of any information about previous community support. Conclusion: The findings allowed the definition of an 'avoidable emergency admission', which is an emergency admission for any symptom or condition that could be supported in a home context or primary health care, or any emergency admission that does not require immediate nursing or medical intervention, nor leads to greater comfort or quality of life for the patient. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Translation, Cross-Cultural Adaptation, and Validation of Measurement Instruments: A Practical Guideline for Novice Researchers.
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Cruchinho, Paulo, López-Franco, María Dolores, Capelas, Manuel Luís, Almeida, Sofia, Bennett, Phillippa May, da Silva, Marcelle Miranda, Teixeira, Gisela, Nunes, Elisabete, Lucas, Pedro, and Gaspar, Filomena
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RESEARCH personnel ,LITERATURE reviews ,PSYCHOMETRICS ,TRANSLATING & interpreting ,CINAHL database - Abstract
Cross-cultural validation of self-reported measurement instruments for research is a long and complex process, which involves specific risks of bias that could affect the research process and results. Furthermore, it requires researchers to have a wide range of technical knowledge about the translation, adaptation and pre-test aspects, their purposes and options, about the different psychometric properties, and the required evidence for their assessment and knowledge about the quantitative data processing and analysis using statistical software. This article aimed: 1) identify all guidelines and recommendations for translation, cross-cultural adaptation, and validation within the healthcare sciences; 2) describe the methodological approaches established in these guidelines for conducting translation, adaptation, and cross-cultural validation; and 3) provide a practical guideline featuring various methodological options for novice researchers involved in translating, adapting, and validating measurement instruments. Forty-two guidelines on translation, adaptation, or cross-cultural validation of measurement instruments were obtained from "CINAHL with Full Text" (via EBSCO) and "MEDLINE with Full Text". A content analysis was conducted to identify the similarities and differences in the methodological approaches recommended. Bases on these similarities and differences, we proposed an eight-step guideline that includes: a) forward translation; 2) synthesis of translations; 3) back translation; 4) harmonization; 5) pre-testing; 6) field testing; 7) psychometric validation, and 8) analysis of psychometric properties. It is a practical guideline because it provides extensive and comprehensive information on the methodological approaches available to researchers. This is the first methodological literature review carried out in the healthcare sciences regarding the methodological approaches recommended by existing guidelines. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Body composition changes in patients with head and neck cancer under active treatment: a scoping review
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Ferrão, Bárbara, Neves, Pedro Miguel, Santos, Teresa, Capelas, Manuel Luís, Mäkitie, Antti, and Ravasco, Paula
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- 2020
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6. Bioelectrical Impedance Analysis (BIA) for the Assessment of Body Composition in Oncology: A Scoping Review.
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Branco, Mariana Garcia, Mateus, Carlota, Capelas, Manuel Luís, Pimenta, Nuno, Santos, Teresa, Mäkitie, Antti, Ganhão-Arranhado, Susana, Trabulo, Carolina, and Ravasco, Paula
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Bioelectrical Impedance Analysis (BIA) is a reliable, non-invasive, objective, and cost-effective body composition assessment method, with high reproducibility. This scoping review aims to evaluate the current scientific and clinical evidence on BIA for body composition assessment in oncology patients, under active treatment. Literature search was conducted through MEDLINE, CINAHL, Scopus and Web of Science databases, following PRISMA-ScR Guidelines. Inclusion criteria comprised studies reporting the use of BIA for body composition evaluation in adults with cancer diagnosis. Studies including non-cancer pathology or only assessing nutritional status were excluded. This scoping review comprised a total of 36 studies: 25 were original studies including 18 prospective studies, six cross-sectional studies and one retrospective study and 11 were systematic reviews. Population size for the included original articles ranged from 18 to 1217 participants, comprising a total of 3015 patients with cancer with a mean baseline Body Mass Index (BMI) ranging from 20.3 to 30.0 kg/m
2 and mean age ranging between 47 and 70 years. Review articles included a total of 273 studies, with a total of 78,350 participants. The current review considered studies reporting patients with head and neck cancer (HNC) (n = 8), breast cancer (BC) (n = 4), esophageal cancer (EC) (n = 2), liver cancer (n = 2), pancreatic cancer (PC) (n = 3), gastric cancer (GC) (n = 3), colorectal cancer (CRC) (n = 8), lung cancer (LC) (n = 1), skin cancer (SK) (n = 1) and multiple cancer types (n = 6). BIA is a suitable and valid method for the assessment of body composition in oncology. BIA-derived measures have shown good potential and relevant clinical value in preoperative risk evaluation, in the reduction of postoperative complications and hospital stay and as an important prognostic indicator in persons with cancer. Future research on the diagnostic value and clinical applications of BIA and BIA-derived phase angle (PhA) should be conducted in order to predict its impact on patient survival and other clinical outcomes. [ABSTRACT FROM AUTHOR]- Published
- 2023
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7. Grieving With Humor: A Correlational Study on Sense of Humor and Professional Grief in Palliative Care Nurses
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Robalo Nunes, Inês, José, Helena, and Capelas, Manuel Luís
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- 2018
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8. Palliative care competencies in nephrology: a scoping review
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Mateus, Ana, Farinha, Ana, Araújo, Manuel, Marques, Susana, Amorim, Joana, Grafino, Mafalda, Pais, Maria João, Capelas, Manuel Luís, and Veritati - Repositório Institucional da Universidade Católica Portuguesa
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Palliative care ,Clinical competence ,Renal insufficiency ,Chronic - Abstract
Introduction: There is a growing need to train nonpalliative physicians in palliative care, as it is increasingly recognized by the medical profession. Political and opinion leaders are also becoming aware of the urgent and growing need for palliative care education. Objective: The aim of this study is to provide an overview of the information available in the literature on the topic of palliative care competencies for nephrologists, using clearly defined and transparent methods to search, summarize, and interpret the relevant literature based on a systematic review approach. Methods: The scoping review is based on the Joanna Briggs Institute methodology. The search was conducted in December 2019 using publications in national and international databases and grey literature in English, Spanish, French and Portuguese. Results: Of the total 4668 publications, 168 were eligible for review based on title and abstract. A full-text review of these 168 publications resulted in the selection of 27 articles that met the predefined inclusion and exclusion criteria and were therefore included in the study. The following competencies were considered necessary to provide high quality PC in various nephrology settings: Communication skills (21.3%); End-of-life care, loss, grief, and bereavement (18.6%); Control of pain and other renal symptoms (16%); Advance care planning (16%); Ethical and legal issues in dialysis decision making (12.2%); Teamwork (6.6%); Ability to provide psychosocial and spiritual support to patients and families (5.6%). Application of palliative care principles (3.7%). Percentage refers to the number of publications addressing each topic. Conclusion: The implementation of an integrated care model that includes both PC and curative treatments places high demands on nephrologists, who must acquire PC competencies. Training in palliative care should be included in the curricula for nephrologists.
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- 2022
9. Protein intake and muscle mass maintenance in patients with cancer types with high prevalence of sarcopenia: a systematic review
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Capitão, Carolina, Coutinho, Diana, Neves, Pedro Miguel, Capelas, Manuel Luís, Pimenta, Nuno, Santos, Teresa, Mäkitie, Antti, Ravasco, Paula, and Repositório da Universidade de Lisboa
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Protein intake ,Body composition ,Muscle wasting ,Cancer ,Nutrition - Abstract
© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021, Rationale: Cancer is associated with muscle wasting. However, optimal protein intake has not been determined, limiting the efficacy of nutritional interventions. This systematic review aims to assess the effect of protein intake on muscle mass of patients with cancer types with high prevalence of sarcopenia during treatment, in longitudinal studies. Methods: MEDLINE, CINAHL, and Scopus databases were searched following PRISMA guidelines. Longitudinal studies written in English, including adults with high sarcopenia prevalence cancer diagnosis, submitted to (chemo)radiotherapy, with assessment of protein intake and muscle changes during treatment, published until 4 October 2020 were included. Studies including supplementation with substances, such as n-3 fatty acids, specific amino acids, or proteins, were excluded. Study appraisal was independently conducted by two reviewers, and a qualitative research synthesis was performed. Results: Overall, 575 records were identified, of which, eight studies were included (one randomized clinical trial and seven uncontrolled before and after studies). Patients with head and neck (n = 5), lung (n = 2), and esophageal cancer (n = 1) were included, comprising a total of 554 participants. The studies presented heterogeneous methodologies, objectives, and methods to assess body composition. Overall, participant groups with a mean protein intake below 1.2 g/kg presented muscle wasting, with one exception, while those reporting a mean intake above 1.4 g/kg, maintained muscle during treatment. Conclusions: Our findings show that protein intakes below 1.2 g/kg, even when within the recommendations, have been associated with muscle wasting during treatment. Only intakes above 1.4 g/kg have been associated with muscle maintenance. High-quality research is needed to establish an optimal dose response.
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- 2021
10. Intervention in the grief process in Portugal by palliative care teams
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Pimenta, Sofia, Capelas, Manuel Luís, and Veritati - Repositório Institucional da Universidade Católica Portuguesa
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Teams ,lcsh:R5-920 ,lcsh:Public aspects of medicine ,Palliative care ,Cuidados Paliativos ,lcsh:RA1-1270 ,Grief ,Luto ,Equipas ,lcsh:Medicine (General) ,Cuidados paliativos - Abstract
Introdução: Os Cuidados Paliativos estendem o seu alvo de atuação à família. Esta última encontra-se numa posição de risco, dada a experiência de doença do seu ente querido e suas consequentes perdas. Este processo de luto deve, deste modo, ser acompanhado, de forma precoce e especializada, pelas equipas. Estas pretendem favorecer a vivência e conclusão do luto de uma forma construtiva para a família. Objetivo: Caracterizar a atuação, no processo de luto, das equipas de cuidados paliativos portuguesas e sua evolução nos anos de 2017 e 2018. Materiais e Métodos: Estudo consistiu na aplicação de um questionário, em 2017 e em 2018, às equipas de cuidados paliativos portuguesas, a fim de caracterizar a sua atuação no processo de luto. Resultados: Nos dois anos, a maioria das equipas detém um programa de apoio no luto formalmente definido. O conjunto de atividades mobilizadas, bem como o timing das mesmas é variável. A chamada telefónica e a consulta de follow-up apresentaram uma redução da sua utilização, no último ano. Esta última, na sua vertente anual, assumiu significância estatística desfavorável. Na participação das atividades, o assistente espiritual apresentou uma evolução positiva. O psicólogo e o enfermeiro foram os que intervieram com maior frequência, para além de terem sido os que mais as registaram. Em 2018 reduziram essa prática. São diversos os locais de registos utilizados pelas equipas, sendo os mais utilizados o SClínico e a ata/papel. Conclusão: A atividade desenvolvida no âmbito do luto diminuiu, estando a maioria das evoluções registadas associada a um agravamento da qualidade dos cuidados prestados pelas equipas., Introduction: Palliative care extends its practice towards the family. The latter finds itself in a position of risk, given the experience of his loved one’s illness and resulting losses. The grieving process must, therefore, be accompanied, early and expertly, by the teams. These aim to favor the experience and conclusion of grief in a constructive way for the family.Aim: To characterize the Portuguese palliative care teams’ performance in the grief process and their evolution between the years 2017 and 2018.Materials and Methods: Application of a questionnaire, in 2017 and 2018, to Portuguese palliative care teams, in order to characterize their role in the grieving process.Results: In the two years, most teams have a formally defined grief support program. The set of mobilized activities, as well as their timing, varies. In the last year, the phone call and the follow-up consultation showed a reduction in their use. The latter showed unfavorable statistical significance in its annual aspect. Partaking in the activities, the spiritual assistant presented a positive evolution. The psychologist and the nurse were the ones who intervened most frequently, as well as the ones who registered them the most. In 2018 this practice reduced. There are several tools of registration used by the teams, the most used being SClínico and minutes/paper.Conclusion: Practice towards the mourning process has declined, taking into account most registered developments resulted from a deterioration in the quality of care provided by the teams.
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- 2020
11. Rethinking palliative care in a public health context: addressing the needs of persons with non-communicable chronic diseases - CORRIGENDUM
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Tziraki, Chariklia, Grimes, Corrina, Ventura, Filipa, O'Caoimh, Ronan, Santana, Silvina, Zavagli, Veronica, Varani, Silvia, Tramontano, Donatella, Apóstolo, João, Geurden, Bart, Luca, Vincenzo de, Tramontano, Giovanni, Romano, Maria Rosaria, Anastasaki, Marilena, Lionis, Christos, Rodríguez-Acuña, Rafael, Capelas, Manuel Luís, Afonso, Tânia dos Santos, Molloy, D. William, Liotta, Giuseppe, Iaccarino, Guido, Triassi, Maria, Eklund, Patrik, Roller-Wirnsberger, Regina, Illario, Maddalena, Tziraki, C., Grimes, C., Ventura, F., O'Caoimh, R., Santana, S., Zavagli, V., Varani, S., Tramontano, D., Apostolo, J., Geurden, B., De Luca, V., Tramontano, G., Rosaria Romano, M., Anastasaki, M., Lionis, C., Rodriguez-Acuna, R., Capelas, M. L., Dos Santos Afonso, T., William Molloy, D., Liotta, G., Iaccarino, G., Triassi, M., Eklund, P., Roller-Wirnsberger, R., Illario, M., and Veritati - Repositório Institucional da Universidade Católica Portuguesa
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palliative care ,multimorbidity ,public health ,Public Health, Environmental and Occupational Health ,Development ,integrated ,non-communicable chronic diseases (NCCDs) ,Care Planning - Abstract
Non-communicable chronic diseases (NCCDs) are the main cause of morbidity and mortality globally. Demographic aging has resulted in older populations with more complex healthcare needs. This necessitates a multilevel rethinking of healthcare policies, health education and community support systems with digitalization of technologies playing a central role. The European Innovation Partnership on Active and Healthy Aging (A3) working group focuses on well-being for older adults, with an emphasis on quality of life and healthy aging. A subgroup of A3, including multidisciplinary stakeholders in health care across Europe, focuses on the palliative care (PC) model as a paradigm to be modified to meet the needs of older persons with NCCDs. This development paper delineates the key parameters we identified as critical in creating a public health model of PC directed to the needs of persons with NCCDs. This paradigm shift should affect horizontal components of public health models. Furthermore, our model includes vertical components often neglected, such as nutrition, resilience, well-being and leisure activities. The main enablers identified are information and communication technologies, education and training programs, communities of compassion, twinning activities, promoting research and increasing awareness amongst policymakers. We also identified key ‘bottlenecks’: inequity of access, insufficient research, inadequate development of advance care planning and a lack of co-creation of relevant technologies and shared decision-making. Rethinking PC within a public health context must focus on developing policies, training and technologies to enhance person-centered quality life for those with NCCD, while ensuring that they and those important to them experience death with dignity.
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- 2020
12. N-3 Fatty Acids Supplementation And Chemotherapy Induced Toxicity: Scoping Review
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Mateus, Carlota, Branco, Mariana Garcia, Neves, Pedro Miguel, Santos, Teresa, Capelas, Manuel Luís, Makitie, Antti, Ravasco, Paula, Mateus, C., Branco, M., Neves, P.M., Branco, T., Capelas, M.L., Makitie, A., and Ravasco, P.
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- 2023
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13. Validation of the Nurse Spiritual Care Therapeutics Scale in Portuguese palliative care settings: a methodological study.
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Santos, Susana, Martins, Helga, Capelas, Manuel Luís, Domingues, Tiago Dias, Caldeira, Sílvia, and Taylor, Elizabeth Johnston
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NURSING audit ,RESEARCH ,RELIABILITY (Personality trait) ,SCIENTIFIC observation ,RESEARCH evaluation ,NURSING specialties ,RESEARCH methodology evaluation ,RESEARCH methodology ,CROSS-sectional method ,PSYCHOMETRICS ,CRONBACH'S alpha ,PEARSON correlation (Statistics) ,FACTOR analysis ,DESCRIPTIVE statistics ,HOSPICE nurses ,STATISTICAL sampling ,DATA analysis software ,PALLIATIVE treatment ,SPIRITUAL care (Medical care) - Abstract
Background: Spirituality is a critical dimension in palliative care, but difficulties have been described in literature concerning the effective implementation and measuring of spiritual care. Aim: To translate, adapt and validate the Nurse Spiritual Care Therapeutics Scale (NSCTS) in Portuguese palliative care settings. Methods: A methodological study was conducted. A final version of the questionnaire included the scale and was submitted to full psychometric testing using nurses working in Portuguese palliative care settings. Findings: A total of 88 nurses participated. The average age of the sample was 36.1 ± 8.93 years (range 23–60 years), and 92.0% were women. A Cronbach alpha value of 0.88; Kaiser-Meyer-Olkin measure of sampling adequacy 0.80; and Bartlett's Test of Sphericity were adequate. An exploratory factor analysis was conducted using principal axis factoring with an oblimin rotation that resulted in a three-factors solution. Conclusion: The European Portuguese NSCTS questionnaire is a valid and reliable tool to assess the frequency of nurses' activities concerning spirituality in palliative care. [ABSTRACT FROM AUTHOR]
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- 2022
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14. Managing Severe Dysgeusia and Dysosmia in Lung Cancer Patients: A Systematic Scoping Review.
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Spencer, Ana Sofia, da Silva Dias, David, Capelas, Manuel Luís, Pimentel, Francisco, Santos, Teresa, Neves, Pedro Miguel, Mäkitie, Antti, and Ravasco, Paula
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MUCOSITIS ,LUNG cancer ,TASTE disorders ,SMELL disorders ,CANCER patients ,NUTRITION counseling - Abstract
Introduction: Lung cancer (LC) is highly prevalent worldwide, with elevated mortality. In this population, taste and smell alterations (TSAs) are frequent but overlooked symptoms. The absence of effective therapeutic strategies and evidence-based guidelines constrain TSAs' early recognition, prevention and treatment (Tx), promoting cancer-related malnutrition and jeopardizing survival outcomes and quality of life. Objectives: To systematically review the literature on TSAs in LC patients, understand the physiopathology, identify potential preventive and Tx strategies and to further encourage research in this area. Methods: Literature search on English language articles indexed to PubMed, CINALH, SCOPUS and Web of Science using MeSH terms "Lung neoplasms","Dysgeusia", "Olfaction Disorders", "Carcinoma, Small Cell","Carcinoma, Non- Small-Cell Lung "Adenocarcinoma of Lung","Carcinoma, Large Cell", and non-MeSH terms "Parageusia", "Altered Taste", "Smell Disorder", "Paraosmia", "Dysosmia","Lung Cancer" and "Oat Cell Carcinoma". Results: Thirty-four articles were reviewed. TSAs may follow the diagnosis of LC or develop during cancer Tx. The estimated prevalence of self-reported dysgeusia is 35-38% in treatment-naïve LC patients, and 35-69% in those undergoing Tx, based on studies involving LC patients only. One prospective pilot trial and 1 RCT demonstrated a clinically significant benefit in combining flavor enhancement, smell and taste training and individualized nutritional counselling; a systematic review, 1 RCT and 1 retrospective study favored using intravenous or oral zinc-based solutions (150mg 2-3 times a day) for the prevention and Tx of chemotherapy (CT) and radiotherapy (RT) -induced mucositis and subsequent dysgeusia. Conclusions: This is the first review on dysgeusia and dysosmia in LC patients to our knowledge. We propose combining taste and smell training, personalized dietary counselling and flavor enhancement with oral zinc-based solutions (150mg, 2-3 times a day) during CT and/or RT in this population, in order to prevent and help ameliorate Tx-induced dysgeusia and mucositis. However due to study heterogeneity, the results should be interpreted with caution. Developing standardized TSA measurement tools and performing prospective randomized controlled trials to evaluate their effect are warranted. [ABSTRACT FROM AUTHOR]
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- 2021
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15. Nutrition and hydration in the end-of-life care: ethical issues
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Pinho-Reis, Cíntia, Sarmento, António, and Capelas, Manuel Luís
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Alimentação oral ,Ethics ,Hidratação artificial ,Nutrição artificial ,End of life ,Ética ,Artificial nutrition ,Palliative care ,Fim de vida ,Artificial hydration ,Oral feeding ,Cuidados paliativos - Abstract
The last decades brought huge advances in medical technology and pharmacology. One area that reflects this progress has been the administration of nutrition and hydration. These are controversial therapies at the end of life, especially when administered by artificial means. The objective of this review was to discuss and comprehend the current and global knowledge about ethical issues related to food, nutrition and hydration in the end-of-life care. The problematic situations analyzed include: advanced directives, the concept of basic human care or treatment, the meaning of food and fluids, the withholding and withdrawing of nutrition and hydration, risks and benefits of nutritional support and the concept of voluntary stopping eating and drinking. As últimas décadas originaram inúmeros avanços na tecnologia médica e farmacológica. Uma das áreas que reflete esse progresso tem sido a administração de alimentação, nutrição e hidratação. Representam áreas controversas do cuidar em fim de vida, especialmente se administradas pela via artificial. O objetivo desta revisão foi discutir e compreender o conhecimento atual e global relativamente às questões éticas relacionadas com a alimentação, nutrição e hidratação no fim de vida. As situações problemáticas analisadas incluíram: diretivas antecipadas de vontade, o conceito de cuidado humano básico ou tratamento, o significado da alimentação e hidratação, a suspensão e abstenção de nutrição e hidratação, riscos e benefícios do suporte nutricional e o conceito da cessação voluntária de nutrição e hidratação.
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- 2018
16. Palliative Patient Safety
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Afonso, Tânia dos Santos, Martins, Lurdes, Capelas, Manuel Luís, and Veritati - Repositório Institucional da Universidade Católica Portuguesa
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lcsh:R5-920 ,Patient safety ,Segurança do utente ,lcsh:Public aspects of medicine ,Palliative care ,lcsh:RA1-1270 ,Fim de vida ,lcsh:Medicine (General) ,Cuidados paliativos ,End-of-life - Abstract
Introduction: The palliative patient is more predisposed to the consequences of the error situations.Aim:To understand patient safety in the context of palliative.Materials and Methods: Integrative literature reviewwhichincluded studies of the last eleven years, using descriptors from Medline, CINAHL Plus with Full Text, and the Portuguese Open Access Scientific Repository. We consider the research question: What is meant by patient safety in need of palliative care?Results: The 11 selected articles develop aspects of user safety around symptomatic control, medication errors, the incidence of home safety, quality of care, route of administration, and palliative sedation.Conclusion: Predominance of the association between safety and mention of errors in medication use. Emerges a suggestion to create an error notification system in a palliative context., Introdução: O utente paliativo encontra-se mais predisposto às consequências das situações de erro.Objetivo:Compreender a segurança do utente no contexto de cuidados paliativos.Materiais e Métodos: Revisão integrativa de literatura que incluiuestudos dos últimos 11 anos, em aplicação dos descritores com proveniência das bases de dados Medline, CINAHL Plus with Full Text e Repositório Científico de Acesso Aberto de Portugal. Considerámos a questão de investigação – o que se entende por segurança do utente com necessidade de cuidados paliativos?Resultados: Os 11 artigos desenvolveram o controlo sintomático, erros de medicação, a incidência da segurança em domicílio, a qualidade de cuidados, via de administração e sedação paliativa.Conclusão: Predominância da associação entre a segurança e a menção a erros de uso de medicação. Emerge a sugestão da criação de um sistema de notificação do erro em contexto paliativo.
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- 2018
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17. Nutrição e hidratação em fim de vida: questões éticas
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Pinho-Reis, Cíntia, Sarmento, António, Capelas, Manuel Luís, and Veritati - Repositório Institucional da Universidade Católica Portuguesa
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Ethics ,Alimentação oral ,Hidratação artificial ,Nutrição artificial ,End of life ,Palliative care ,Ética ,Fim de vida ,Artificial hydration ,Oral feeding ,Cuidados paliativos - Abstract
The last decades brought huge advances in medical technology and pharmacology. One area that reflects this progress has been the administration of nutrition and hydration. These are controversial therapies at the end of life, especially when administered by artificial means. The objective of this review was to discuss and comprehend the current and global knowledge about ethical issues related to food, nutrition and hydration in the end-of-life care. The problematic situations analyzed include: advanced directives, the concept of basic human care or treatment, the meaning of food and fluids, the withholding and withdrawing of nutrition and hydration, risks and benefits of nutritional support and the concept of voluntary stopping eating and drinking., As últimas décadas originaram inúmeros avanços na tecnologia médica e farmacológica. Uma das áreas que reflete esse progresso tem sido a administração de alimentação, nutrição e hidratação. Representam áreas controversas do cuidar em fim de vida, especialmente se administradas pela via artificial. O objetivo desta revisão foi discutir e compreender o conhecimento atual e global relativamente às questões éticas relacionadas com a alimentação, nutrição e hidratação no fim de vida. As situações problemáticas analisadas incluíram: diretivas antecipadas de vontade, o conceito de cuidado humano básico ou tratamento, o significado da alimentação e hidratação, a suspensão e abstenção de nutrição e hidratação, riscos e benefícios do suporte nutricional e o conceito da cessação voluntária de nutrição e hidratação.
- Published
- 2018
18. Psychometric properties of the 28-Item General Health Questionnaire in nurses: a proposal with 24 items.
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Seabra, Paulo, Capelas, Manuel Luís, Oliveira Lopes, Joaquim, Calado, Mariana, and Pessoa, Ezequiel
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RESEARCH methodology evaluation , *RESEARCH methodology , *MENTAL health , *HEALTH status indicators , *PSYCHOMETRICS , *PSYCHOLOGY of nurses , *QUESTIONNAIRES , *FACTOR analysis , *DESCRIPTIVE statistics , *RECEIVER operating characteristic curves , *STATISTICAL correlation , *STATISTICAL sampling , *DATA analysis software , *EVALUATION - Abstract
Background: The psychometric properties of measurement instruments should be assessed in different populations. Objective: To analyze the psychometric properties of the 28-Item General Health Questionnaire (GHQ-28) in nurses. Methodology: Methodological validation study of measurement instruments. Analysis of psychometric properties, exploratory factor analysis (EFA) by the principal component analysis method, and Receiver Operating Characteristic (ROC) curve, with a nonprobability sample of 1,264 nurses. Results: EFA suggests keeping four factors and deleting four items in 3 dimensions (items 3, 16, 21, and 26). The variance explained by the 4 factors was 61.5%, and Cronbach's alpha was 0.93. The general health scores did not change significantly after deleting the 4 items. The comparison between the 24-item version and the 28-item version revealed an area under the curve (AUC) of0.996 (p < 0.001) and a cutoff point of 20.5, with a 96.3% sensitivity and a 98.4 specificity. Conclusion: The reassessment of the psychometric properties of GHQ-28 in nurses suggests a reduction to 24 items. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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19. Nursing education on palliative care across Europe: Results and recommendations from the EAPC Taskforce on preparation for practice in palliative care nursing across the EU based on an online-survey and country reports.
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Martins Pereira, Sandra, Hernández-Marrero, Pablo, Pasman, H Roeline, Capelas, Manuel Luís, Larkin, Philip, and Francke, Anneke L
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PALLIATIVE care nursing ,REPORT writing ,INTERNET ,RESEARCH methodology ,CURRICULUM ,NURSING education ,HUMAN services programs ,SURVEYS ,DESCRIPTIVE statistics ,NURSES ,PROFESSIONAL competence - Abstract
Background: Nurses are the largest regulated group of healthcare professionals involved in palliative care. In 2004, a taskforce of the European Association for Palliative Care (EAPC) launched the 'Guide for development of palliative nurse education in Europe' (hereinafter, the EAPC 2004 Guide). No systematic evaluation of its impact in the development of palliative care education was undertaken. Aims: To describe current undergraduate and postgraduate nursing education across Europe; to identify the roles that nurses with different palliative care educational levels have in palliative care; and to assess the uptake of the EAPC 2004 Guide in the development of palliative care nursing in Europe. Design: Descriptive research involving an online survey among nursing experts, and the consultation of national representatives. Setting/participants: A total of 135 nurses (52% response rate) from 25 countries completed the online survey; representatives from 16 countries were consulted. Results: In 14 (56%) countries, palliative care was not identified as a mandatory subject within undergraduate nursing education. The EAPC 2004 Guide is widely known and was/is being used in many countries to promote palliative care nursing education. Large variations were found across and within country responses. Conclusions: Palliative care nursing education varies largely in Europe. The wide awareness and use of the EAPC 2004 Guide show how policy measures can influence the development of palliative care education. Recommendations are built and focus on both fostering the use of this guide and implementing policy measures to ensure that palliative care nursing is recognised and certified as a specialty in all European countries. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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20. A INFLUÊNCIA DAS CARTAS TERAPÊUTICAS NA ESPERANÇA DOS PAIS DE CRIANÇAS COM DOENÇA CRÓNICA THE INFLUENCE OF THE THERAPEUTIC LETTERS IN THE HOPE OF PARENTS OF CHILDREN WITH CHRONIC ILLNESS
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Fonseca, Ricardo, Charepe, Zaida, and Capelas, Manuel Luís
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- 2015
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21. A national survey of the nurses' mental health — The case of Portugal.
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Seabra, Paulo Rosário Carvalho, Lopes, Joaquim Manuel de Oliveira, Calado, Mariana Esteves, and Capelas, Manuel Luís
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AGE distribution ,CHI-squared test ,CONFIDENCE intervals ,EXPERIMENTAL design ,HEALTH attitudes ,HEALTH status indicators ,LEISURE ,MENTAL health ,MULTIVARIATE analysis ,NURSES ,NURSES' attitudes ,SCIENTIFIC observation ,QUESTIONNAIRES ,RESEARCH ,SEX distribution ,SHIFT systems ,SLEEP ,STATISTICS ,SURVEYS ,WORK environment ,EMPLOYEES' workload ,DATA analysis ,QUANTITATIVE research ,LIFESTYLES ,DATA analysis software ,DESCRIPTIVE statistics ,ODDS ratio ,MANN Whitney U Test ,KRUSKAL-Wallis Test ,PSYCHOLOGICAL factors - Abstract
Aim: To understand Portuguese nurses' perceptions of their mental health. Background: The impact of nurses' health and well‐being on the quality and safety of the care they provide is well known. In Portugal, there are no representative studies regarding nurses' mental health. Materials and Methods: Transversal, analytical, and observational methods were used, with a quantitative approach. Participants answered questions through an online form. We collected data concerning social‐professional characterization, general health status, and mental health. The General Health Questionnaire‐28 (GHQ‐28) was used. Results: A total of 1264 nurses participated in a nonrandomized sample. Two‐thirds revealed a negative perception of their mental health. Of these, 22.2% reported severe depression symptoms, 71.6% indicated significant somatic symptoms, 76% showed significant anxiety, and 94.1% presented some kind of social dysfunction. Conclusion: Better mental health is associated with being part of a larger household, enjoying more hours of sleep, having more free weekends, being male, working as a specialist, and engaging in leisure activities. Worse mental health is associated with being older, having a longer career, working more hours, and practicing in the hospital context. Implications for nursing practice: The professionals' living and working conditions must be addressed by their managers. [ABSTRACT FROM AUTHOR]
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- 2019
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22. Clinical Validation of the Portuguese Version of "Substance Addiction Consequences" Derived from the Nursing Outcomes Classification.
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Seabra, Paulo Rosário Carvalho, Amendoeira, José Joaquim Penedos, Sá, Luis Octávio, and Capelas, Manuel Luís Vila
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ANALYSIS of variance ,STATISTICAL correlation ,FACTOR analysis ,MENTAL health ,NOSOLOGY ,NURSING ,PSYCHOMETRICS ,QUALITY of life ,RESEARCH evaluation ,STATISTICAL sampling ,STATISTICS ,SUBSTANCE abuse ,RESEARCH methodology evaluation ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
Our aim was to contribute to the clinical validation of "Substance Addiction Consequences" (SAC) derived from the nursing outcomes classification (NOC), and to analyse psychometric properties. To that purpose, we applied a methodological design. The study's outcome comprises 16 nursing-sensitive indicators, within four different consequence factors: psychological and family; physical and cognitive ability; self-care; economic and work. The psychometric properties were considered good. We concluded that the scale can be used as a valid tool to measure the consequences of substance addiction and to assess the health status as a nursing sensitive outcome. The scale is considered valid to monitor nursing interventions in the clinical setting; being a comprehensive tool it allows the nurse to understand better this complex health problem. [ABSTRACT FROM AUTHOR]
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- 2018
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23. Depression and Spiritual Distress in Adult Palliative Patients: A Cross-Sectional Study.
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Velosa, Teresa, Caldeira, Sílvia, and Capelas, Manuel Luís
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PSYCHOLOGICAL distress ,PALLIATIVE treatment ,MENTAL depression ,RELIGION - Abstract
Palliative care patients have been associated with a high probability of having depression and spiritual distress. However, there is a gap in research about the clinical indicators that can promote an effective differential diagnosis of depression and spiritual distress. This study aimed to identify the prevalence and the clinical indicators of depression and spiritual distress in palliative patients in primary care. An observational and cross-sectional study was conducted in 2016 in a Portuguese primary care unit. From a General Practitioners patients' file of 1457 adult patients, a sample of 30 palliative patients was recruited throughout two steps: (1) selection of patients with chronic disease criteria; (2) selection of patients with Prognostic Indicator Guidance criteria. Exclusion criteria included cognitive impairment and psychotic disorders. Participants completed the self-assessment Hospital Anxiety and Depression Scale (HADS) and Functional Assessment of Chronic Illness Therapy--Spiritual Well-Being Scale (FACIT-Sp12) scales, which were sealed in opaque envelopes. Clinical data collection used semi-structured interviews for the diagnosis of depression and spiritual distress. The prevalence of depression was 23% (n = 7), while the prevalence of spiritual distress was 23% (n = 7). Four patients (13%) fulfilled both the depression and the spiritual distress criteria. Depression and spiritual distress seem to be both linked to the spiritual dimensions of the human being, but seem to differ in the dimensions of suffering and pharmacologic treatment. [ABSTRACT FROM AUTHOR]
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- 2017
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24. Experiences of Homeless Families in Parenthood: A Systematic Review and Synthesis of Qualitative Evidence.
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Andrade, Filipa Maria Reinhardt, Simões Figueiredo, Amélia, Capelas, Manuel Luís, Charepe, Zaida, and Deodato, Sérgio
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- 2020
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25. Portugal is making great strides with the support of its national association.
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Vila Capelas, Manuel Luís and Fernandes Coelho, Silvia Patricia
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- 2014
26. Quality assessment in palliative care - an overview.
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Vila Capelas, Manuel Luís, Vicuna, Maria Nabal, and Rosa, Fernando Coelho
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- 2013
27. Implementing spiritual care at the end of life: Portugal.
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Caldeira, Sílvia, Pinto, Sara, and Capelas, Manuel Luís
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- 2017
28. Palliative care in non-cancer patients: AIDS, critically ill & neurological diseases
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Capelas, Manuel Luís and Veritati - Repositório Institucional da Universidade Católica Portuguesa
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Public health ,Medicina ,Saúde pública ,education ,Palliative care ,Medicine ,Cuidados paliativos - Abstract
This is the first of two volumes dedicated to palliative care for patients with non-cancer diseases, to help health professionals, students and society in general, to find strategies to provide better care to these patients. Were invited professionals and researchers of recognized international merit, who have collaborated with the Universidade Católica Portuguesa in the training in palliative care of our students. In this first volume, we will address the interventions among patients with progressive neurological disease, AIDS and the critical patient (emergency and intensive care). In the second issue, we will cover palliative care in patients with chronic heart, respiratory and renal disease. Manuel Luís Capelas, PhD, Assistant Professor at the Institute of Health Sciences of UCP and Codirector of the Portuguese Observatory for Palliative Care Palliative This work is a relevant and timely contribution in strengthening knowledge about Palliative Care in groups of patients traditionally excluded from our services, such as those with non-cancer and degenerative diseases, but including those who use services as diverse as intensive care and emergency services. It is important, on this occasion, to leave a word of deep thanks and appreciation to the experts involved in the preparation of this book.
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- 2019
29. Palliative care in non-cancer patients: heart failure, end-stage renal disease & chronic lung disease
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Capelas, Manuel Luís and Veritati - Repositório Institucional da Universidade Católica Portuguesa
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Public health ,Medicina ,Saúde pública ,education ,Palliative care ,Medicine ,Cuidados paliativos - Abstract
According the Worldwide Palliative Care Alliance, Stephen Connor and Xavier Goméz-Batiste, the heart failure, the chronic lung disease (namely the chronic obstructive pulmonary disease) and the end-stage renal disease are, respectively, the first, third and sixth disease which the people with palliative care need are more prevalent. This, second of two books dedicated to palliative care for non-cancer patients aims to help health professionals, students and society in general, to find strategies to provide the best possible care to patients and their families. Namely, in this book, we approach the intervention to improve the quality of life of the patients who live with chronic heart, lung or kidney disease. The authors are professionals and researchers of recognized international merit, who have collaborated with the Universidade Católica Portuguesa in the training in palliative care of its students.
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- 2019
30. Internship report on palliative care at St Catherine's hospice
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Monteiro, Andreia Marlene da Silva, Capelas, Manuel Luís, and Charman, David
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Submitted by Cristina Afonso (cac@lisboa.ucp.pt) on 2016-09-13T15:23:23Z No. of bitstreams: 1 relatóriofinal13abril.pdf: 10954071 bytes, checksum: 18782e4fca2c1c15ba6d41e08744bf05 (MD5) Approved for entry into archive by Cristina Afonso (cac@lisboa.ucp.pt) on 2016-09-13T15:23:34Z (GMT) No. of bitstreams: 1 relatóriofinal13abril.pdf: 10954071 bytes, checksum: 18782e4fca2c1c15ba6d41e08744bf05 (MD5) Made available in DSpace on 2016-09-13T15:23:34Z (GMT). No. of bitstreams: 1 relatóriofinal13abril.pdf: 10954071 bytes, checksum: 18782e4fca2c1c15ba6d41e08744bf05 (MD5) Previous issue date: 2016-04-14
- Published
- 2016
31. The impact of pre-, pro- and synbiotics supplementation in colorectal cancer treatment: a systematic review.
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Moreira MM, Carriço M, Capelas ML, Pimenta N, Santos T, Ganhão-Arranhado S, Mäkitie A, and Ravasco P
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Introduction: The effectiveness of the supplementation of prebiotics, probiotics and synbiotics as a therapeutic approach in colorectal cancer (CRC) remains unclear. The aim of this systematic review is to critically examine the current scientific evidence on the impact of modulating the microbiota, through the use of prebiotics, probiotics and synbiotics, in patients diagnosed with CRC undergoing treatment, to determine the potential therapeutic use of this approach., Methods: This systematic review was made according to the PRISMA 2020 guidelines. Inclusion criteria were randomized controlled trials (RCT) comparing the impact of pre-, pro-, or synbiotic supplementation with placebo or standard care in patients with CRC undergoing treatment. Exclusion criteria were non-human studies, non-RCTs, and studies in languages other than English or Portuguese. Six databases were consulted, namely, Cochrane Library, Pubmed, Scopus, Cinahl, MedicLatina and Web of Science until May of 2023. RAYYAN software was used to manage the search results and risk of bias was assessed according to the guidelines of the Cochrane Collaboration using the Rob 2.0 tool., Results: Twenty-four RCTs met the inclusion criteria and were included in this review. Administration of pre-, pro-, or synbiotics improved surgical outcomes such as the incidence of infectious and non-infectious postoperative complications, return to normal gut function, hospital length of stay, and antibiotic usage. The supplementation of these microorganisms also alleviated some symptoms from chemotherapy and radiotherapy, mainly diarrhea. Evidence on the best approach in terms of types of strains, dosage and duration of intervention is still scarce., Conclusions: Pre-, pro-, and synbiotics supplementation appears to be a beneficial therapeutic approach in CRC treatment to improve surgical outcomes and to alleviate side-effects such as treatment toxicity. More RCTs with larger sample sizes and less heterogeneity are needed to confirm these potential benefits and to determine the best strains, dosage, and duration of administration in each situation., Systematic Review Registration: https://www.crd.york.ac.uk/prospero, identifier CRD42023413958., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Moreira, Carriço, Capelas, Pimenta, Santos, Ganhão-Arranhado, Mäkitie and Ravasco.)
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- 2024
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32. Peristomal infection after percutaneous endoscopic gastrostomy: a 7-year surveillance of 297 patients.
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Duarte H, Santos C, Capelas ML, and Fonseca J
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- Anti-Bacterial Agents therapeutic use, Antibiotic Prophylaxis, Cefazolin therapeutic use, Cross Infection microbiology, Cross Infection prevention & control, Female, Gastrostomy methods, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Surgical Wound Infection microbiology, Surgical Wound Infection prevention & control, Cross Infection epidemiology, Gastrostomy adverse effects, Surgical Stomas microbiology, Surgical Wound Infection epidemiology
- Abstract
Context: Healthcare-associated infection represents the most frequent adverse event during care delivery. Medical advances like percutaneous endoscopic gastrostomy have brought improvement on quality of life to patients but an increased risk of healthcare-associated infection. Predictive risk factors for peristomal wound infection are largely unknown but evidence suggests that antibiotic prophylaxis and preventive strategies related to infection control may reduce infection rates., Objectives: The primary aim was to evaluate the global prevalence rate of peristomal infection. Secondary objectives were to characterise the positive culture results, to evaluate the prophylactic antibiotic protocol and to identify potential risk factors for peristomal infection., Methods: Retrospective study of 297 patients with percutaneous endoscopic gastrostomy performed at a general hospital between January 2004 and September 2010. Patients received prophylactic cefazolin before the endoscopic gastrostomy procedure. Medical records were reviewed for demographic data, underling disease conditions to percutaneous endoscopic gastrostomy and patient potential intrinsic risk factors. Statistical analysis was made with the statistical program SPSS 17.0., Results: A total of 297 percutaneous endoscopic gastrostomy tubes were inserted. Wound infection occurred in 36 patients (12.1%). Staphylococcus aureus methicillin resistant was the most frequently isolated microorganism (33.3%) followed by Pseudomonas aeruginosa (30.6%). The incidence rate had been rising each year and differ from 4.65% in 2004/2007 to 17.9% in 2008/2010. This finding was consistent with the increasing of prevalence global infection rates of the hospital. Most of the infections (55.6%) were detected in the first 10 days post procedure. There was no significant difference in age, body mass index values, mean survival time and duration of percutaneous endoscopic gastrostomy feeding between patients with and without periostomal infection. Institutional factors, namely global prevalence infection rates and the endemic character of Staphylococcus aureus methicillin resistant, play an important role in peristomal infection rates. Traditional antibiotic prophylaxis with cefazolin is not adequate due to the prevalence of resistant organisms., Conclusions: Peristomal infection is a frequent problem with clinical impact in percutaneous endoscopic gastrostomy patients and should be considered a healthcare associated infection. The antimicrobial prophylaxis regimens using cephalosporins are not adequate and need to be reviewed due to the high prevalence of Staphylococcus aureus methicillin resistant and other resistant organisms in hospitals and nursing homes.
- Published
- 2012
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