ESS - NEU - Posters apresentados em eventos científicos
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- Formação pedagógica a educadores clínicos – a experiência da ESS |P.Porto em Fisiologia ClínicaPublication . Baeta, Cristina; Tavares, Diana; Salgado, AnaA educação clínica integrada num ciclo de estudos (CE) de licenciatura na área da saúde sempre se revestiu de especial importância, dado ser o momento/contexto em que o estudante tem possibilidade de aplicar as suas competências teóricas/práticas adquiridas previamente no CE, assim como desenvolver outras fundamentais na área de atuação de um licenciado em Fisiologia Clínica, como comunicação/interação com o doente/utente, trabalho em equipa, gestão de conflitos, assunção de responsabilidades e resolução de problemas. Esta integração no ambiente clínico é organizada pelo coordenador de curso e/ou docentes responsáveis pelo estágio clínico, contudo os monitores de estágio constituem, na prática, o real veículo de inclusão e desenvolvimento eficaz do estudante. Nestes últimos anos esta tarefa tornou-se cada vez mais difícil, devido às exigências burocráticas/profissionais impostas aos serviços hospitalares/clínicos e aos seus profissionais. As áreas responsáveis por este CE conjuntamente com a responsável do centro pedagógico, idealizaram e implementaram uma formação pedagógica para os educadores clínicos, de forma a existir um momento anual de reflexão sobre todo o processo, os aspetos onde se devem implementar melhorias e sobretudo uma partilha de experiências. Este ano, pela primeira vez, este evento foi realizado em formato online, tendo sido uma experiência bastante positiva e ainda assim muita interativa. Recolheu-se a perceção dos participantes desta formação, sendo que 60% considerou que a formação correspondeu “bastante” às expetativas e os restantes “completamente”. O feedback obtido demonstrou que estas iniciativas são pertinentes, devem ser realizadas periodicamente e que o formato online em nada lesou a mensagem a transmitir, de tal forma que a partilha de experiências foi extraordinariamente profícua.
- Ética e deontologia nas tecnologias da saúdePublication . Cruz, Agostinho; Lopes, Paula; Amorim, Manuela; Cabral, Ana Paula; Curado, Henrique; Faria, Isabel; Gonçalves, Maria João; Machado, Alberto; Sousa, Helena; Monteiro, Pedro; Tavares, DianaMuitas são as Instituições de Ensino Superior (IES) que ministram cursos na área da saúde e onde são desenvolvidos estudos de cariz clínico, sendo necessário garantir a salvaguarda dos padrões de (bio)ética, por forma a proteger e garantir a dignidade e integridade humana e a proteção/segurança dos seus dados pessoais. O Decreto-Lei n.º 80/2018 (15 /outubro), veio estabelecer princípios e regras aplicáveis ao funcionamento das comissões de ética integradas em IES, que realizem investigação clínica. A Comissão de Ética da Escola Superior de Saúde (CE da ESS) do Politécnico do Porto tem 10 anos de existência, desenvolvendo atividade de apoio aos projetos de investigação integrados em cursos de graduação e/ou dos seus Centros de Investigação, ou de entidades externas. Assim, para além da análise e emissão de pareceres relativos à investigação realizada, a CE da ESS tem intervém ainda no eixo da formação, objetivando padrões conduta (bio)ética, proteção e garantia da dignidade/integridade humana e proteção/segurança dos dados pessoais e/ou sensíveis, segundo os Códigos Deontológicos e de Conduta das Tecnologias da Saúde. Nestas áreas da saúde, os dilemas surgem no dia-a-dia dos profissionais e são devidos tanto às diferentes patologias, como aos procedimentos de diagnóstico e terapêutica utilizados. Existe ainda a problemática da confidencialidade e registo, que tem vindo a assumir cada vez maior importância, com o incremento da autonomia do paciente / utente. O respeito pelos direitos do utente, nas questões relativas ao controlo e acesso à informação clínica e terapêutica, pressupõe conhecimento e experiência do profissional quanto aos limites ético-deontológicos, dada a gestão constante do risco inerente à intervenção, tendo em vista o objetivo último da mesma: o bem-estar de quem procura estes profissionais.
- Post-Therapy Epilepsy Prevalence in Patients with High-Grade Gliomas: a systematic review and meta-analysisPublication . Borges, Daniel Filipe; Soares, Joana I.; Casalta-Lopes, João; Ferreira, Marta Pereira; Carvalho, RubenHigh-grade gliomas are the most common type of malignant glioma. Seizures are frequently the first clinical manifestation of high-grade gliomas. Seizure-control is one of the main goals of treatment due to the impact in quality of life of these patients. Besides it impacts in morbidity and mortality rates there is a lack of evidence in the prevalence of post- therapy epilepsy. Our main goal was to evaluate the prevalence of epilepsy after the end of high-grade gliomas treatment. Our search was conducted across PubMed®️, EMBASE®️, Web of Science™️, Cochrane Library, Sicelo and Scopus, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We included all studies conducted on adults with newly diagnosed high-grade gliomas, who were treated with at least surgery or radiotherapy, and assessed for long-term side-effects (accounting for seizures) and published in Portuguese or English. Thirty-six studies were included in the meta-analysis, encompassing a total of 4036 patients with high-grade gliomas. Patient’s mean age ranged from 44 to 73 years, with a diagnosis of glioblastoma in 77,8% of all patients. Pretreatment seizures were observed in 21,2% of all cases. Surgery was the main treatment for all studies, with 1842 patients undergoing adjuvant therapy. Our meta-analysis identified a pooled prevalence of post-therapy seizures of 25.5%, with a 95% confidence interval of [19.9%;31.1%] (Z=8.90, p<.001). A significant heterogeneity between studies was observed (I2=96%, Q(35)=784, p<.001) with no significant asymmetry in funnel plot analysis (Z=1.27, p=.20). High-grade gliomas are a recognized trigger for seizures. A high heterogeneity in all the evaluated variables was observed. To minimize the diversity of results, a larger prospective studies using appropriate epilepsy diagnostic techniques would be beneficial to have a more exact number of the high-grade glial patients that develop post-therapy epilepsy.
- The effects of 24-hour sleep deprivation on the human brain: a multimodal neurophysiological approachPublication . Gonçalves, Alice; Pinto, Sara; Ferreira, Simão; Borges, Daniel FilipeIntroduction: Sleep is an important aspect of human health and well-being and influences various physiological and cognitive functions such as learning and attention. On the other hand, sleep deprivation activates the sympathetic nervous system, negatively impacting blood pressure, heart rate, glucose metabolism, cortisol, and hormones. It alters mood, behaviour, and reduces awareness leading to a poor performance, hence the importance of studying the neurophysiological and neurocognitive effects of 24h sleep deprivation. Objective: Our main goal is to investigate the effects of acute sleep deprivation on the cerebral cortex in healthy university students using a multimodal approach and neurocognitive scales. Methods: This study will use a magnetic stimulator to assess neurophysiological changes, while actigraphy will verify sleep deprivation in the intervention group. Neuropsychological assessments include the Trail Making Test (TMT), measuring visual processing speed and cognitive flexibility, the Psychomotor Vigilance Task (PVT), assessing sustained attention through reaction times to unpredictable stimuli and N-Back test measuring working memory by requiring participants to recall objects presented a few steps earlier. EEG data will be recorded using a cap with 32 channels during. This integrated approach provides a comprehensive analysis of the effects of sleep deprivation on cognitive and neurophysiological functions. Expected Results: Hypothetically, there will be a significant decline in cognitive performance, with impairments in key areas such as visual attention, processing speed and cognitive flexibility. These results will likely manifest in longer reaction times, more frequent errors and overall lower task execution.
- Wearable sleep staging technology as an alternative to polysomnography: a systematic review and meta-analysisPublication . Borges, Maria; Pereira, Telmo; Borges, Daniel Filipe; Soares, Joana IsabelIntroduction:Sleep is vital for health as it has regenerative and protective functions. During sleep, there is a cyclicity of different phases that are analysed and classified for clinical purposes using polysomnography (PSG), a costly and technically demanding method. The tremendous growth of sleep medicine, where demand for studies far outstrips supply, opens a window for the development of accurate, low-threshold sleep monitoring solutions that can be self-administered at home and could help avoid these issues of convenience, accessibility and reproducibility. Objective:This study aims to analyse the existing literature on the feasibility of wearable devices as an alternative to PSG for the classification of sleep stages. Methods: The literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). All studies published in English or Portuguese with healthy adults who used wearables to record sleep were included. A meta-analysis was also performed to assess the mean values of the sleep metrics: total sleep time (TST), sleep latency (SL) and wake after sleep onset (WASO), all in minutes and time per stage (in minutes and as relative frequency of TST), as well as sleep efficiency (SE) (in %) and the corresponding statistics between the wearables used and the PSG. Results: Given the high variability of wearables, the analysed metrics whose values were closest to the PSG came from different devices. Nevertheless, the meta-analysis revealed that most wearables tend to overestimate these variables Conclusions: The performance of wearables demonstrates remarkable accuracy in sleep staging, rivalling the gold standard PSG in some variables while providing a more convenient and unobtrusive alternative. This review enriches our global knowledge of sleep measurement and summarizes the limitations that need to be overcome, as informed decision making depends on understanding the different device options, validation contexts and cost implications.
- Ictal and interictal source connectivity during gelastic seizures in a focal cortical dysplasia of the cingulate gyrusPublication . Borges, Daniel Filipe; Dias, Daniela; Cordeiro, Helena; Leal, AlbertoGelastic seizures are rare manifestations of epilepsy often associated with hypothalamic hamartomas (HH). In the absence of HH, localization of the origin is more difficult and there are several less well-established possibilities. Non-invasive assessment is often complicated by the deep localization of the epileptogenic area and the complex dynamics of spike activity. Robust neurophysiologic methods and careful validation of intrinsically epileptogenic lesions detected by RM can improve the validity of scalp EEG analysis. To analyze the dynamics of epileptic activity in gelastic seizures associated with cortical dysplasia. A 26-year-old girl with daily refractory gelastic seizures since the age of 6 underwent a neurophysiological assessment with long-term EEG recordings (24h, 31 channels) and an MRI of the brain. She had previously been rejected in an epilepsy surgery program because no structural brain lesion had been found and the EEG information was not informative enough. A recent 3T MRI showed cortical dysplasia in the cingulate gyrus, which was highly suspicious as an epileptogenic focus. We analyzed the 31-channel EEG (ictal and interictal) using source and functional connectivity methods to obtain a solid computer model of the origin and dynamics of epileptic activity and correlate it with the anatomical information of the MRI. Source analysis of interictal activity revealed multiple sources that dominated at different time points, indicating considerable dynamics that prevented clear source identification. The ictal recordings demonstrated barely late rhythmic activity over the frontal areas, but no early focalization. Connectivity analysis, which revealed the flow of information between cortical sources, showed a consistent origin of epileptic activity in the vicinity of cortical dysplasia for both interictal and ictal activity. EEG connectivity analysis significantly improves the performance of non-invasive methods for determining intracranial dynamics of epileptic activity and correlation with structural lesions.
- Neurophysiological evaluation of undergraduate portuguese young adults with regarding difficultiesPublication . Alves, Marta; Pinto, Patrícia; Tavares, Diana; Santos, AnaReading is a complex cognitive process that requires a simultaneous activation of different brain systems. Power EEG has been used to study activation patterns in dyslexic subjects, but so far, studies lack result’s coherence, including in adult dyslexic population. The Reading Age Test (TIL) is a screening assessment for dyslexia. TIL evaluates the processes of decoding and understanding. This test is adapted and validated to Portuguese language. Objective: To analyze neurophysiological differences in undergraduate adults with and without reading difficulties using power EEG, and compare the results with the ones found at younger ages. Methods: 209 college students were administered the TIL. EEG was collected with 26 students (21 within normal reading level; 5 with severe reading difficulties signalized with TIL). During the EEG, the participant was asked to follow a sequence of tasks, during a total of 15 minutes (Basal resting state, TIL, Pos-TIL resting state, Non-reading Task; final resting state). Subsequently, the Fourier Transform (FFT) algorithm was applied to the EEG signal from the Basal resting state and the two given tasks. Power spectra mean values of delta, theta and beta activity band, from electrodes F7, F8, T3, T4, T5 and T6 were analyzed performing Shapiro-Wilk tests. Results: No significant differences in mean variations (sig >0.05) were observed between groups during the analyzed periods, regarding electrode and brain activity band frequency. Conclusion: This study provided inconclusive results concerning power EEG different findings at the lower frontal gyrus region and temporal region, between subject with and without reading difficulties.
- Alterações no trato urinário inferior na polineuropatia amiloidótica familiar: abordagem urodinâmicaPublication . Lopes, A.; Bairres, M.; Braga, I.; Principe, P.; Fraga, A.A polineuropatia amiloidótica familiar (PAF) é uma polineuropatia de pequenas fibras com afetação do sistema nervoso autónomo. Como tal, pode manifestar-se por disfunção na fisiologia da micção e condicionar o aparecimento de sintomatologia vesico-esfincteriana, muitas vezes de início precoce. A abordagem urodinâmica revela ser um útil método de diagnóstico capaz de demonstrar alterações no trato urinário inferior e contribuir para a terapêutica urológica atempada, podendo evitar consequências graves no trato urinário superior e proporcionar a estes doentes uma vida com qualidade, adiando a sua incapacidade.
- Neuromarketing: Validation through neurophysiological techniquesPublication . Pereira, Ana; Tavares, Diana; Pimenta, RuiNeuromarketing is a new theme that allows the combination of neuroscience with marketing permitting to test advertising campaigns, feelings or emotions and even taken more accurately decisions. The Neuromarketing, simplistically, tries to give each product or service the characteristic of "perfect". Determine the changes caused in the EEG signal by different external stimuli presented, in particular, the sound of the ads and the emotions that each one awakens in the subjects. Infer about the ability of each advertisement capture more or less the attention of individuals before a specific ad.
- Analysis of oscillatory brain activity in gamers and non-gamers during different cognitive tasksPublication . Duarte, Vinicius; Dores, Artemisa Rocha; Tavares, DianaSome studies suggest that the pathological use of video games is related to high impulsivity and risky decision making. To analyze the EEG activity of compulsive gamers and non-gamers, while performing one inhibitory control and a decision-making task.