Browsing by Author "Costa, P."
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- Current practices in home mechanical ventilation for chronic obstructive pulmonary disease: A real-life cross-sectional multicentric studyPublication . Ribeiro, C.; Vieira, A. L.; Pamplona, P.; Drummond, M.; Seabra, B.; Ferreira, D.; Liberato, H.; Carreiro, A.; Vicente, I.; Castro, Luísa; Costa, P.; Carriço, F.; Martim, T.; Cravo, J.; Teixiera, N.; Grafino, M.; Conde, S.; Windisch, W.; Nunes, R.Home mechanical ventilation (HMV) use in chronic obstructive pulmonary disease (COPD) is becoming increasingly widespread. The aim of this study was to provide an accurate description of the current practices and clinical characteristics of COPD patients on HMV in Portugal. The study was designed as a cross-sectional, multicenter real-life study of COPD patients established on HMV for at least 30 days. Data related to clinical characteristics, adaptation and ventilatory settings were collected. The study included 569 COPD patients on HMV from 15 centers. The majority were male, with a median age of 72 years and a high prevalence of obesity (43.2%) and sleep apnea (45.8%). A high treatment compliance was observed (median 8h/day), 48.7% with inspiratory positive airway pressure ≥ 20 cmH2O and oronasal masks were the preferred interface (91.7%). There was an equal distribution of patients starting HMV during chronic stable condition and following an exacerbation. Patients in stable condition were initiated in the outpatient setting in 92.3%. Despite the differences in criteria and setting of adaptation and a slightly lower BMI in patients starting HMV following an exacerbation, we found no significant differences regarding age, gender, ventilation pressures, time on HMV, usage, severity of airflow obstruction or current arterial blood gas analysis (ABGs) in relation to patients adapted in stable condition. Patients were highly compliant with the therapy. In agreement with most recent studies and recommendations, there seems to be a move towards higher ventilation pressures, increased use of oronasal masks and an intent to obtain normocapnia. This study shows that chronic hypercapnic and post exacerbation patients do not differ significantly regarding patient characteristics, physiological parameters or ventilatory settings with one exception: chronic hypercapnic patients are more often obese and, subsequently, more frequently present OSA.
- Development of a framework for radiographer online clinical education (FORCE): the specifc strand of nuclear medicine within this european projectPublication . Costa, P.; Atutornu, J.; Bezzina, P.; Dalen, N.; Huhtanen, J.; Jaronen, M.; Saila, T.; Kraus, B.; Rainford, L.; Matthews, K.The overall aim of the FORCE project is to develop virtual web-based learning resources where Radiography undergraduates can engage in interactive, problem-based development of radiographic knowledge, ability and professional awareness. This European-funded project is internally divided in three diferent strands (Radiology Diagnostic Imaging, Radiotherapy and Nuclear Medicine). The aim of this presentation is to present the global project, mainly focusing developments, achievements and challenges within the Nuclear Medicine specifc strand.
- Modification of [18F]-FDG PET/CT imaging protocols in obese oncology patients: A nationwide surveyPublication . Oliveira, R.; Figueiredo, L.; Costa, P.The use of medical imaging for diagnosis, staging and follow-up in Oncology context is incredibly important, being the use of [18F]-FDG PET/CT particularly advantageous in specific contexts like the case of obese patients. However, imaging the latter can be challenging sometimes, since their own body size may affect overall image quality and adds technical difficulties for the operator(s) performing the examination. This research project was developed with the aim of analysing the current personal practices of Portuguese Nuclear Medicine Technologists (NMTs) in the adaptation of 18F-FDG PET/CT oncological protocols for obese patients and comparing the results with parameters referenced in literature. A non-experimental research study was conducted using a survey delivered online to NMTs through social media platforms (Facebook® and LinkedIn®) and by sending the link directly to contacts within the research team professional and personal networks. Answers from a total of 26 participants were obtained, with 88.5% of participants admitting modifying technical protocols in examinations for obese patients. Changes in PET protocols included an increase in the administered activity (60.9%), an increase in scan time per individual bed position (69.6%) and the use of Time-of-Flight (TOF) technology whenever available. Protocol changes in CT included increasing the mA (82.6%), raising the KVp (47.8%), the application of iterative reconstruction (69.6%) and the use of automatic exposure control (AEC) (52.2%). The remaining parameters (pitch, algorithm, slice thickness, display FOV, gantry rotation time and energy acceptance window) were claimed not to be modified by around 90% of professionals. Portuguese NMTs tend to change the [18F]-FDG PET/CT protocols for obese patients. However, while some of the parameters appear to be contradictory or redundant, others require further optimisation, especially in the CT component.
- Study of radiobiological effects of low doses of ionizing radiation using comet assay on zebrafish modelPublication . Lemos, Joana; Costa, Pedro; Cunha, Lídia; Carvalho, A.; Neuparth, T.; Vasconcelos, Vítor; Genésio, P.; Ponte, F.; Costa, P.; Crespo, P.; Metelo, Luís F.Present paper relates with the analysis of radiobiological effects, in a context of ionizing radiation low doses, using an advanced biological model, the zebrafish - Danio rerio - and comet assay based analytical methodology. The use of zebrafish has grown considerably in recent years, assuming more and more is role as a very promising model in biomedical research, both because of the high level of homology shared with the human genome, and an assumedly easy - and reasonably priced - practical side. To obtain the data here mentioned, it has been used a population of circa 300 animals, divided in four groups of 75 each, all having been externally irradiated with three distinct dose protocols: 100, 500 and 1.000 mGy. The postures of the irradiated fish were collected and groups of adult animals were killed in three different moments: 1, 4 and 7 days after the irradiation. DNA damage in adults and in larvae were studied using comet assay. The results related to damages were processed and presented in terms of percentual of DNA in tail, allowing an approximation to the relative number of DNA breaks induced by the radiation exposure.