Browsing by Author "Alves, Pedro"
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- Musicians noise exposure in a Portuguese orchestra – a case studyPublication . Rodrigues, Matilde; Alves, Pedro; Ferreira, Luis; Neves, Paula; Aguiar, Livia; Vieira Da Silva, ManuelaExposure to high noise levels is broadly recognized as being one of the most significant and frequent risk factors in occupational environments, particularly at industrial settings (Arezes et al., 2012). Such exposure can result in several effects for the workers' health, mainly in the development of noise-induced hearing loss (NIHL), which is the most frequent occupational disease in Europe (EU-OSHA, 2002). However, there are other professionals groups that are also considered as important, concerning noise exposure. The professional orchestras musicians are one of these groups. Previous studies show that orchestral musicians are exposed to loud music (Lee et al., 2005; MacDonald et al., 2008; O’Brien et al., 2008), which can have a great impact on their health. However, despite the relevance of this issue for orchestral musicians, it seems that the problematic of noise exposure is still not well characterized, and the strategy for the noise exposure assessment not well established. Furthermore, the Portuguese legislation, in particular the Decreto-Lei nº 182/2006, does not consider the specific case of musicians, and there is no code of conduct provided in accordance with Directive 2003/10/CE that establishes the guidelines about how musicians should be protected from noise exposure. This is particularly critical considering that the hearing ability of these musicians is a relevant part and a crucial tool of their professional activity and performance (Jansen et al., 2009; Kähäri et al., 2004). Besides, without a reliable risk assessment of musicians' exposure, it is not possible to compare sound pressure levels with the current guidelines and it is also very complex to define and implement an effective strategy to reduce the risk of NIHL (Arezes et al., 2012).
- Warfarin–Supplement Interactions: A Systematic ReviewPublication . Alves, Pedro; Carreira, Bruno; Nogueira, Gonçalo; Sousa, Mariana; Cruz, Agotinho; Cruz, AgostinhoFood supplements, which are concentrated forms of nutrients, play a crucial role in maintaining a balanced diet by providing essential missing nutrients. However, their impact on drug interactions cannot be overlooked. One such drug is warfarin, which is an anticoagulant with a complex interplay involving various medications, foods, and supplements. Given the significant increase in the use of dietary supplements in reent years, there is a compelling rationale to investigate their interactions with warfarin. This systematic review aims to identify supplements that interact with warfarin, thereby providing insights into potential risks and implications. In order to address the research question “What potential drug in‑ teractions may arise when food supplements are taken concomitantly with warfarin?”, a PRISMA 2020 systematic review was conducted. To accomplish a comprehensive under‑ standing of the issue at hand, several databases were consulted. In order to fulfill the search platforms’ requirements, the terms “interactions”, “warfarin”, and “supplements” were combined in multiple ways. The inclusion criteria took into account original, ran‑ domized or non‑randomized studies and case studies that mention a supplement used concomitantly with warfarin. An artificial intelligence‑based tool was used to evaluate the studies’ quality. The obtained results were summarized in a table format, detailing the supplement used and the how the interaction occurs. A search of the literature yielded 968 articles, of which 14 were selected for review. These articles met the specified criteria, namely the use of a dietary supplement concomitantly with warfarin. Of these, 11 indicated a potential interaction, while three articles suggested that no interaction occurred. This work clarified the interactions between supplements and warfarin, emphasizing supplements such as dong quai, milk thistle, and American ginseng, which alter the mechanism of action of the drug. Furthermore, it is imperative for patients to seek counsel from healthcare professionals before modifying their dietary regimen.