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São João da Madeira, Portugal

Nunes S.T.,University of Porto | Nunes S.T.,Centro Hospitalar Of S Joao | Rego G.,University of Porto | Nunes R.,University of Porto
CIN - Computers Informatics Nursing

Health information systems are becoming common because they are important tools to support decision making and assist nurses in their daily interventions. The Information System for Nursing Practice promotes consistent nursing records, as it is directed to the nursing practice and process. The aims of this study were to identify and describe the most frequent type of nursing actions in the care plan for a patient after acute myocardial infarction, considering the seven-axis model of the International Classification of Nursing Practice and the rate of health education given to patients during hospitalization. A cross-sectional analysis was performed retrospectively by searching the computerized database of the Information System for Nursing Practice. We verified some gaps in information with regard to unidentified records of diagnoses and interventions. During hospitalization, the most used interventions were in the fields of observing (40%) and managing (23%). Interventions associated with management of signs and symptoms were more frequent and were performed in 84.9% of the patients. In the field of informing, health education in relation to diet was performed in 21.7% of the patients; exercise, in 16%; and tobacco, in 11.3%. The use of nursing records and information systems can improve nursing care coordination and care plan management. © 2014 Wolters Kluwer Health. Source

Nunes J.B.,University of Porto | Peixoto J.,University of Porto | Soares P.,University of Porto | Maximo V.,University of Porto | And 11 more authors.
Human Molecular Genetics

Mitochondria are central organelles for cellular metabolism. In cancer cells, mitochondrial oxidative phosphorylation (OXPHOS) dysfunction has been shown to promote migration, invasion, metastization and apoptosis resistance. With the purpose of analysing the effects of OXPHOS dysfunction in cancer cells and the molecular players involved, we generated cybrid cell lines harbouring either wild-type (WT) or mutant mitochondrial DNA (mtDNA) [tRNAmut cybrids, which harbour the pathogenic A3243T mutation in the leucine transfer RNA gene (tRNAleu)]. tRNAmut cybrids exhibited lower oxygen consumption and higher glucose consumption and lactate production than WT cybrids. tRNAmut cybrids displayed increased motility and migration capacities, which were associated with altered integrin-β1 N-glycosylation, in particular with higher levels of β-1,6- N-acetylglucosamine (GlcNAc) branched N-glycans. This integrin-β1 N-glycosylation pattern was correlated with higher levels of membrane-bound integrin-β1 and also with increased binding to fibronectin. When cultured in vitro, tRNAmut cybrids presented lower growth rate thanWTcybrids, however, when injected in nude mice, tRNAmut cybrids produced larger tumours and showed higher metastatic potential than WT cybrids. We conclude that mtDNA-driven OXPHOS dysfunction correlates with increased motility and migration capacities, through a mechanism that may involve the cross talk between cancer cell mitochondria and the extracellular matrix. © The Author 2014. Published by Oxford University Press. Source

Giugliani R.,Medical Genetics Service | Guffon N.,Hopital Femme Mere Enfant | Ketteridge D.,Womens and Childrens Hospital | Leao-Teles E.,Centro Hospitalar Of S Joao | And 6 more authors.
American Journal of Medical Genetics, Part A

Mucopolysaccharidosis VI (MPS VI) is a clinically heterogeneous and progressive disorder with multiorgan manifestations caused by deficient N-acetylgalactosamine-4-sulfatase activity. A cross-sectional Survey Study in individuals (n=121) affected with MPS VI was conducted between 2001 and 2002 to establish demographics, urinary glycosaminoglycan (GAG) levels, and clinical progression of disease. We conducted a Resurvey Study (ClinicalTrials.gov: NCT01387854) to obtain 10-year follow-up data, including medical histories and clinical assessments (n=59), and survival status over 12 years (n=117). Patients received a mean (SD) of 6.8 (2.2) years of galsulfase ERT between baseline (Survey Study) and follow-up. ERT patients increased in height by 20.4cm in the 4-7-year-old baseline age group and by 16.8cm in the 8-12-year-old baseline age group. ERT patients <13 years-old demonstrated improvement in forced vital capacity (FVC) by 68% and forced expiratory volume in 1sec (FEV1) by 55%, and those ≥13 years-old increased FVC by 12.8% and maintained FEV1. Patients with >200μg/mg baseline uGAG levels increased FVC by 48% in the <13-year-old baseline age group and by 15% in the ≥13-year-old baseline age group. ERT patients who completed the 6-min walk test demonstrated a mean (SD) increase of 65.7 (100.6)m. Cardiac outcomes did not significantly improve or worsen. Observed mortality rate among naïve patients was 50% (7/14) and 16.5% (17/103) in the ERT group (unadjusted hazard ratio, 0.24; 95% CI, 0.10-0.59). Long-term galsulfase ERT was associated with improvements in pulmonary function and endurance, stabilized cardiac function and increased survival. © 2014 Wiley Periodicals, Inc. Source

Nunes S.R.T.,University of Porto | Nunes S.R.T.,Centro Hospitalar Of S Joao | Rego G.,University of Porto | Nunes R.,University of Porto
Experimental and Clinical Cardiology

To optimally improve health status after a myocardial infarction it is essential for patients to understand the seriousness of the disease and improve their self-management. Aims: To describe patients' perceptions of preventive care, after experiencing a first episode of an acute myocardial infarction in a central hospital in Portugal and to analyze the intent to change behaviors and real changes six months after myocardial infarction. Methods: Longitudinal descriptive study; 106 patients aged between 35 and 64 years, who had cardiovascular risk factors and a first experience of myocardial infarction were selected. Data was collected in two structured interviews. Results: Of the patients, 18% had never, by their own accord, chosen to use preventive care services. During hospitalization, 43% described preventive care as a negative perception. Patients showed intent to change their habits but after discharge, they had difficulties in self-management of disease, maintaining monitoring or changing their cardiovascular risk factors such as physical activity (41%), blood pressure (37%), and eating habits (24%). Conclusions: There were considerable discrepancies between the intention and action in behavioral changes in patients after a myocardial infarction. Regarding the patients' perceptions, there is a need to improve their involvement in the management of disease. © 2013 et al.; licensee Cardiology Academic Press. Source

Araujo J.,University of Porto | Severo M.,University of Porto | Barros H.,University of Porto | Mishra G.D.,University of Queensland | And 3 more authors.
International Journal of Obesity

Objective:To identify developmental trajectories of adiposity from birth until early adulthood, and to investigate how they relate with cardiometabolic risk factors at 21 years of age.Methods:Participants' weight and height measurements were obtained using the EPITeen cohort protocol at 13, 17 and 21 years of age, and extracted from child health books as recorded during health routine evaluations since birth. Blood pressure, triglycerides, cholesterol and insulin resistance (HOMA-IR) were assessed at 21 years. Trajectories were defined using 719 participants contributing 11 459 measurements. The individual growth curves were modelled using mixed-effects fractional polynomial, and the trajectories were estimated using normal mixture modelling for model-based clustering. Differences in cardiometabolic risk factors at 21 years according to adiposity trajectories were estimated through analysis of covariance (ANCOVA), and adjusted means are presented.Results:Two trajectories - 'Average body mass index (BMI) growth' (80.7%) and 'Higher BMI growth' (19.3%) - were identified. Compared with those in 'Average BMI growth', 'Higher BMI growth' participants were more frequently delivered by caesarean section, mothers were younger and had higher BMI, and parental education was lower; and at 21 years showed higher adjusted mean systolic (111.6 vs 108.3 mm Hg, P<0.001) and diastolic blood pressure (71.9 vs 68.4 mm Hg, P<0.001), and lower high-density lipoprotein cholesterol (53.3 vs 57.0 mg dl -1, P=0.001). As there was a significant interaction between trajectories and sex, triglycerides and HOMA-IR were stratified by sex and we found significantly higher triglycerides, in males, and higher HOMA-IR in both sexes in 'Higher BMI growth' trajectory. All the differences were attenuated after adjustment for BMI at 21 years.Conclusions:In this long-term follow-up, we were able to identify two adiposity trajectories, statistically related to the BMI and cardiometabolic profile in adulthood. Our results also suggest that the impact of the adiposity trajectory on cardiometabolic profile is mediated by current BMI. © 2015 Macmillan Publishers Limited. Source

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