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- Acute effects of physical exercise with microcurrent in the adipose tissue of the abdominal region: A randomized controlled trialPublication . Noites, Andreia; Moreira, Anabela; Melo, Cristina; Faria, Miriam; Vilarinho, Rui; Freitas, Carla; Monteiro, Pedro; Carvalho, Paulo; Adubeiro, Nuno; Sousa, Maria; Santos, Rubim; Nogueira, LuisaIncreased abdominal fat and sedentary lifestyles contribute to cardiovascular disease risk. Low-intensity electrical current (microcurrent) on the abdominal region, associated with physical exercise, appears to be an innovative method to increase the lipolytic rate of abdominal adipocytes, in order to reduce abdominal fat. This study aimed to analyze the acute effects of microcurrent associated with an aerobic exercise program in healthy subjects in lipolysis. A double-blinded, randomized controlled trial was developed and conducted in a higher education school. Eighty-three healthy subjects, aged between 18 and 30 years old and with a 18.5 to 29.9 kg/m2 body mass index were randomly assigned either to an experimental or to a placebo group. Subjects received a trans-abdominal microcurrent stimulation for 40 min with (experimental group) or without (placebo group) electrical current, followed by a single aerobic exercise session (60 min at 45–55% VO2max intensity). Lipolytic activity (serum glycerol), abdominal fat (waist circumference, abdominal skinfold, ultrasonography), and serum lipid profile (serum triglyceride, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol) were evaluated in all subjects. Physical activity (International Physical Activity Questionnaire) and dietary intake (food-frequency questionnaire) questionnaires were applied. After the intervention, lipolytic rate was significantly higher (p = 0.003) in the experimental group (mean = 0.15) than in the placebo group (mean = 0.09). Glycerol results showed a statistically significant increase between baseline and after the intervention for both experimental group (p = 0.001) and the placebo group (p = 0.001). Combined use of microcurrent and physical aerobic exercise had an acute effect enhancing lipolytic rate comparing to exercise alone, in young healthy subjects.
- Análise da influência do apoio podálico em radiografias de face dos joelhos em cargaPublication . Silva, Sandra; Pereira, José ManuelIntrodução – A articulação do joelho é das mais complexas do corpo humano e das mais afetadas pela osteoartrose uma vez que sustenta a maior parte do peso corporal. As alterações do alinhamento dos seus componentes podem conduzir ao desequilíbrio biomecânico e promover a redução do espaço articular. Apesar de outras modalidades de imagem serem utilizadas, neste contexto a radiologia convencional constitui, ainda, um instrumento indispensável na avaliação imagiológica do joelho. Contudo, não é consensual qual o protocolo mais adequado para a sua avaliação. Objetivos – O objetivo principal deste estudo centrou-se na análise da influência do apoio podálico, bi ou mono, na imagem radiográfica resultante da incidência de face do joelho em carga. Material e métodos – Realizou-se um estudo institucional, observacional, transversal e retrospetivo, incidindo sobre indivíduos, adultos, submetidos a um exame radiográfico de face dos joelhos em carga, com apoio bipodálico e monopodálico no mesmo episódio de exame. Foram aplicadas técnicas de medição do espaço articular e do ângulo femorotibial em todas as imagens recolhidas e comparadas as medições entre as imagens com apoio monopodálico e bipodálico. Resultados – A amostra foi composta por 30 indivíduos (63,3% do género feminino) com uma média de idades de 60,9 anos (±10,4 anos). A partir desta amostra foram constituídos dois grupos, um composto pelos joelhos direitos (n=21) e o outro pelos joelhos esquerdos (n=27). O espaço articular do compartimento medial apresentou-se como o mais diminuído em ambos os grupos. Comparando as médias das medições do espaço articular nas imagens adquiridas com apoio monopodálico e bipodálico observaram-se diferenças com significância estatística quer no joelho direito (p<0,001) quer no esquerdo (p<0,001). Observaram-se ainda diferenças na amplitude do ângulo femorotibial entre as imagens com apoio mono e bipodálico. Conclusão – Os resultados obtidos apontam para que a incidência de face em carga do joelho realizada com apoio monopodálico promove uma redução do espaço articular do compartimento afetado e, consequentemente, o aumento do espaço articular do compartimento contralateral.
- Análise de repetição de exames em radiologia convencionalPublication . Freitas, Artur; Pereira, José Manuel; Pereira, José ManuelA Radiologia Convencional é o método de primeira linha no diagnóstico de diversas patologias e avaliação da anatomia. A repetição de exames relaciona-se com o não cumprimento de critérios de boa realização que resultem em ausência/insuficiência de valor diagnóstico. A diminuição da taxa de repetição representa um fator importante na área da radiologia e da saúde comunitária, contribuindo para a diminuição da dose recebida pelos doentes e profissionais de saúde. O objetivo principal deste estudo foi determinar os exames de radiologia convencional mais suscetíveis de serem repetidos pelos técnicos de radiologia, e causas associadas. Realizou-se um estudo analítico, observacional e transversal. Os dados foram colhidos através da aplicação online de um inquérito por questionário aos participantes no estudo. A população em estudo consistiu em técnicos de radiologia portugueses, licenciados em radiologia ou imagem médica e radioterapia, a exercer funções em Portugal ou no estrangeiro. Para o estudo de associações entre variáveis, utilizaram-se os testes estatísticos de Correlação de Pearson e Qui-quadrado da independência. A amostra foi constituída por 228 participantes, dos quais 176 (77,2%) do sexo feminino, com média de idade de 33.93 (±10.37) anos e tempo médio de experiência profissional de 10.58 (±10.34) anos. O exame ao joelho (61%) foi considerado pelos participantes como o mais provável de ser repetido, seguido do tórax (29.4%) e ombro (24.6%). Os participantes apontaram como erro técnico mais comum o posicionamento incorreto, sendo a não colaboração do doente, o principal fator preditor de erro técnico. Observou-se uma correlação negativa de fraca amplitude entre o tempo de experiência dos profissionais e a frequência com que repetem exames radiológicos. Os exames realizados ao joelho, ombro e tórax, são aqueles que apresentam maior taxa de repetição, sendo o erro mais comum o posicionamento incorreto do doente. O fator que mais contribui para o erro é a não colaboração do doente. Os participantes realçam a necessidade do desenvolvimento de programas de formação contínua e a introdução de pequenas pausas durante os turnos.
- Apparent diffusion coefficient in the analysis of prostate cancer: determination of optimal b-value pair to differentiate normal from malignant tissuePublication . Adubeiro, Nuno; Nogueira, Maria Luísa; Nunes, Rita G.; Ferreira, Hugo Alexandre; Ribeiro, Eduardo; La Fuente, José Maria FerreiraPurpose Determining optimal b-value pair for differentiation between normal and prostate cancer (PCa) tissues. Methods Forty-three patients with diagnosis or PCa symptoms were included. Apparent diffusion coefficient (ADC) was estimated using minimum and maximum b-values of 0, 50, 100, 150, 200, 500 s/mm2 and 500, 800, 1100, 1400, 1700 and 2000s/mm2, respectively. Diagnostic performances were evaluated when Area-under-the-curve (AUC) > 95%. Results 15 of the 35 b-values pair surpassed this AUC threshold. The pair (50, 2000 s/mm2) provided the highest AUC (96%) with ADC cutoff 0.89 × 10–3 mm2/s, sensitivity 95.5%, specificity 93.2% and accuracy 94.4%. Conclusions The best b-value pair was b = 50, 2000 s/mm2.
- Application of MRI and Biomedical Engineering in Speech Production StudyPublication . Ventura, Sandra Moreira Rua; Freitas, Diamantino Rui; Tavares, João ManuelSpeech production has always been a subject of interest both at the morphological and acoustic levels. This knowledge is useful for a better understanding of all the involved mechanisms and for the construction of articulatory models. Magnetic resonance imaging (MRI) is a powerful technique that allows the study of the whole vocal tract, with good soft tissue contrast and resolution, and permits the calculation of area functions towards a better understanding of this mechanism. Thus, our aim is to demonstrate the value and application of MRI in speech production study and its relationship with engineering, namely with biomedical engineering. After vocal tract contours extraction, data were processed for 3D reconstruction culminating in model construction of some of the sounds of European Portuguese. MRI provides useful morphological data about the position and shape of the different speech articulators, and the biomedical engineering computational tools for its analysis.
- Application of the diffusion kurtosis model for the study of breast lesionsPublication . Nogueira, Luísa; Brandão, Sofia; Matos, Eduarda; Nunes, Rita Gouveia; Loureiro, Joana; Ramos, Isabel; Ferreira, Hugo AlexandreObjectives To evaluate diffusion-weighted imaging (DWI) and diffusion kurtosis imaging (DKI) in the differentiation and characterisation of breast lesions. Methods Thirty-six women underwent breast magnetic resonance imaging (MRI) including a DWI sequence with multiple b-values (50–3,000 s/mm2). Mean values for apparent diffusion coefficient (ADC), mean diffusivity (MD) and mean kurtosis (MK) were calculated by lesion type and histological subtype. Differences and correlation between parameters were determined. Results Forty-four lesions were found. There were significant differences between benign and malignant lesions for all parameters (ADC, p = 0.017; MD, p = 0.028; MK, p = 0.017). ADC and MD were higher for benign (1.96 ± 0.41 × 10−3 and 2.17 ± 0.42 × 10−3 mm2/s, respectively) than for malignant lesions (1.33 ± 0.18 × 10−3 and 1.52 ± 0.50 × 10−3 mm2/s). MK was higher for malignant (0.61 ± 0.27) than benign lesions (0.37 ± 0.18). We found differences between invasive ductal carcinoma (IDC) and fibroadenoma (FA) for all parameters (ADC, MD and MK): p = 0.016, 0.022 and 0.016, respectively. FA and fibrocystic change (FC) showed differences only in MK (p = 0.016). Conclusions Diffusion in breast lesions follows a non-Gaussian distribution. MK enables differentiation and characterisation of breast lesions, providing new insights into microstructural complexity. To confirm these results, further investigation in a broader sample should be performed.
- Associations between nutrition, energy expenditure and energy availability with bone mass acquisition in dance students: a 3-year longitudinal studyPublication . Amorim, Tânia; Freitas, Laura; Metsios, George S.; Thayse, Natacha Gomes; Wyon, Matthew; Flouris, Andreas D.; Maia, José; Marques, Franklim; Nogueira, Luísa; Adubeiro, Nuno; Koutedakis, YiannisThree years of study showed that female and male vocational dancers displayed lower bone mass compared to controls, at forearm, lumbar spine and femoral neck. Energy intake was found to positively predict bone mass accruals only in female dancers at femoral neck. Vocational dancers can be a risk population to develop osteoporosis.
- Bone mineral density in vocational and professional ballet dancersPublication . Amorim, T.; Koutedakis, Y.; Nevill, A.; Wyon, M.; Maia, J.; Machado, J. C.; Marques, F.; Metsios, G.S.; Flouris, A.D.; Adubeiro, Nuno; Nogueira, L.; Dimitriou, L.According to existing literature, bone health in ballet dancers is controversial. We have verified that, compared to controls, young female and male vocational ballet dancers have lower bone mineral density (BMD) at both impact and non-impact sites, whereas female professional ballet dancers have lower BMD only at non-impact sites.
- Breast DWI at 3 T: influence of the fat-suppression technique on image quality and diagnostic performancePublication . Nogueira, Luisa; Brandão, Sofia; Nunes, Rita G.; Ferreira, Hugo Alexandre; Loureiro, Joana; Ramos, IsabelAim To evaluate two fat-suppression techniques: short tau inversion recovery (STIR) and spectral adiabatic inversion recovery (SPAIR) regarding image quality and diagnostic performance in diffusion-weighted imaging (DWI) of breast lesions at 3 T. Materials and methods Ninety-two women (mean age 48 ± 12.1 years; range 21–78 years) underwent breast MRI. Two DWI pulse sequences, with b-values (50 and 1000 s/mm2) were performed with STIR and SPAIR. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), suppression homogeneity, and apparent diffusion coefficient (ADC) values were quantitatively assessed for each technique. Values were compared between techniques and lesion type. Receiver operating characteristics (ROC) analysis was used to evaluate lesion discrimination. Results One hundred and fourteen lesions were analysed (40 benign and 74 malignant). SNR and CNR were significantly higher for DWI-SPAIR; fat-suppression uniformity was better for DWI-STIR (p < 1 × 10−4). ADC values for benign and malignant lesions and normal tissue were 1.92 × 10−3, 1.18 × 10−3, 1.86 × 10−3 s/mm2 for DWI-STIR and 1.80 × 10−3, 1.11 × 10−3, 1.79 × 10−3 s/mm2 for SPAIR, respectively. Comparison between fat-suppression techniques showed significant differences in mean ADC values for benign (p = 0.013) and malignant lesions (p = 0.001). DWI-STIR and -SPAIR ADC cut-offs were 1.42 × 10−3 and 1.46 × 10−3 s/mm2, respectively. Diagnostic performance for DWI-STIR versus SPAIR was: accuracy (81.6 versus 83.3%), area under curve (87.7 versus 89.2%), sensitivity (79.7 versus 85.1%), and specificity (85 versus 80%). Positive predictive value was similar. Conclusion The fat-saturation technique used in the present study may influence image quality and ADC quantification. Nevertheless, STIR and SPAIR techniques showed similar diagnostic performances, and therefore, both are suitable for use in clinical practice.
- Burnout among portuguese radiographers during the COVID-19 pandemicPublication . Pereira, José Manuel; Silva, C.; Freitas, D.; Salgado, A.The COVID-19 pandemic has had a global impact, including in health services, placing health professionals under enormous tension, pressure, and stress. Professionals involved in the care, diagnosis, and treatment of COVID-19-infected patients have been subject to emotional and physical distress that can potentially enhance the development of occupational diseases. The aim of this study was to assess the impact of the COVID-19 pandemic on the incidence of burnout among Portuguese radiographers. This was a cross-sectional, quantitative study. Burnout levels were estimated using the Mas lach Burnout Inventory-Human Services Survey, composed of 22 questions. Specific questions were developed to characterize the socio-demographic situation and the impact of the pandemic on the radiographers. Data were descriptively analyzed and ManneWhitney and KruskaleWallis tests were used for correlation analysis. The study sample comprised 386 radiographers, 68.7% of whom where female and 31.3% male. The mean sample age was 36.3 (±9.1) years. A total of 43.5% and 45.5% of subjects had a high level of emotional exhaustion and depersonalization, respectively, and 59.8% experienced low personal accom plishment. Altogether, 23.3% of study participants were at high risk of burnout in the three dimensions assessed and 77.2% in at least one. Study results showed that radiographers were at high risk of developing burnout in the COVID-19 pandemic setting. Health institutions should actively monitor these professional's mental health and develop restorative strategies that enable their emotional wellbeing, preventing absenteeism and increasing patients' quality of care. Implications for practice: Burnout of health professionals has a strong impact on health services orga nization, resulting in increased absenteeism and error probability, frequent work delays, low productivity and job satisfaction, inter- and intra-professional conflicts, high job turnover, high job quit, and decreased quality of care perceived by users.